{"hospital_name":"RIVERSIDE COMMUNITY HOSPITAL","last_updated_on":"2024-10-01","version":"2.2.0","affirmation":{"affirmation":"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.","confirm_affirmation":true},"hospital_location":["RIVERSIDE COMMUNITY HOSPITAL"],"hospital_address":["4445 MAGNOLIA AVENUE, Riverside, CA, 92501"],"license_information":{"hospital_license_number":"250000194","state":"CA"},"standard_charge_information":[{"description":"CATH BLNDIL 2.75MM 6MM ","code_information":[{"code":"184732","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4439.00,"discounted_cash":4439.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1997.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2358.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1462.21,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1758.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1953.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3995.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":989.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":665.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3773.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3018.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1331.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1282.87,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 20MM 1.5MM ","code_information":[{"code":"182631","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 22MM 2X75CM ","code_information":[{"code":"24729","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10977.00,"discounted_cash":10977.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2085.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2085.63,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4939.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5830.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3615.82,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4349.09,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2700.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2700.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4829.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9879.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2447.87,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8781.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1646.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8781.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9330.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7464.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8781.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3293.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3172.35,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 2MM 100MM ","code_information":[{"code":"184225","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9882.00,"discounted_cash":9882.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1877.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1877.58,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4446.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5249.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3255.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3915.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2430.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2430.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4348.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8893.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2203.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1482.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8399.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6719.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2964.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2855.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 2MM 15MM ","code_information":[{"code":"184717","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4439.00,"discounted_cash":4439.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1997.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2358.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1462.21,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1758.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1953.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3995.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":989.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":665.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3773.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3018.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1331.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1282.87,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 2MM 30MM ","code_information":[{"code":"468599","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 2MM0MM ","code_information":[{"code":"468605","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 2X40X150CM ","code_information":[{"code":"22849","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21852.00,"discounted_cash":21852.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9833.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11607.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7198.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8657.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9614.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19666.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4873.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3277.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18574.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14859.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6555.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6315.23,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.25MM 142CM ","code_information":[{"code":"182678","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.25MM 20MM ","code_information":[{"code":"184748","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.25MM 8MM ","code_information":[{"code":"46814","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.5MM 135CM ","code_information":[{"code":"386518","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.5MM 15MM ","code_information":[{"code":"918992","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.5MM 6MM ","code_information":[{"code":"184750","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4439.00,"discounted_cash":4439.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1997.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2358.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1462.21,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1758.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1953.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3995.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":989.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":665.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3773.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3018.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1331.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1282.87,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.5X150 AMDP ","code_information":[{"code":"355152","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11430.00,"discounted_cash":11430.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2171.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2171.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5143.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6071.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3765.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4528.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2811.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2811.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5029.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10287.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2548.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9144.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1714.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9144.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9715.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7772.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9144.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3429.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3303.27,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.5X80X150CM ","code_information":[{"code":"352149","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.75MM 142CM ","code_information":[{"code":"182706","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.75MM 20MM ","code_information":[{"code":"919025","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3.75MM 8MM ","code_information":[{"code":"918942","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3MM 135CM ","code_information":[{"code":"386517","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3MM 20MM ","code_information":[{"code":"919001","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3MM 60MM ","code_information":[{"code":"352155","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9882.00,"discounted_cash":9882.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1877.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1877.58,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4446.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5249.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3255.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3915.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2430.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2430.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4348.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8893.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2203.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1482.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8399.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6719.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2964.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2855.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3MM0MM ","code_information":[{"code":"468597","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3X20X150 ","code_information":[{"code":"351654","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21852.00,"discounted_cash":21852.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9833.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11607.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7198.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8657.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9614.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19666.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4873.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3277.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18574.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14859.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6555.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6315.23,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 3X60MM 150CM ","code_information":[{"code":"360146","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6976.00,"discounted_cash":6976.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1325.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1325.44,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3139.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3705.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2297.89,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2763.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1716.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1716.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3069.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6278.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1555.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1046.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5929.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4743.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2092.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2016.06,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4.5MM 15MM ","code_information":[{"code":"184807","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4439.00,"discounted_cash":4439.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":843.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1997.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2358.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1462.21,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1758.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1091.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1953.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3995.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":989.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":665.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3773.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3018.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3551.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1331.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1282.87,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4.5MM 8MM ","code_information":[{"code":"918944","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM 120MM ","code_information":[{"code":"920716","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5538.00,"discounted_cash":5538.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1052.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1052.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2492.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2941.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1824.22,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2194.16,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1362.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1362.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2436.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4984.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1234.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4430.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":830.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4430.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4707.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3765.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4430.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1661.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1600.48,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM 150MM ","code_information":[{"code":"388860","type":"CDM"},{"code":"C2623","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31430.00,"discounted_cash":31430.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5971.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5971.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14143.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16695.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10353.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12452.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7731.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7731.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13829.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28287.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7008.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25144.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4714.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25144.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26715.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":21372.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25144.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9429.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9083.27,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM 20MM ","code_information":[{"code":"184802","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM 30MM ","code_information":[{"code":"919038","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM 6MM ","code_information":[{"code":"184798","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4213.00,"discounted_cash":4213.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":800.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1895.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2237.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1387.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1669.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1036.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1853.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3791.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":939.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":631.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3581.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2864.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3370.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1263.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1217.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4MM0MM ","code_information":[{"code":"46819","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4939.00,"discounted_cash":4939.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":938.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":938.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2222.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2623.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1626.91,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1956.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1214.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1214.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2173.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4445.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1101.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3951.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":740.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3951.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4198.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3358.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3951.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1481.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1427.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDIL 4X15MM 137CM ","code_information":[{"code":"381746","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9576.00,"discounted_cash":9576.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1819.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1819.44,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4309.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5086.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3154.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3794.01,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2355.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2355.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4213.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8618.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2135.45,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7660.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1436.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7660.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8139.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6511.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7660.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2872.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2767.46,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL 5X80X80 ","code_information":[{"code":"184393","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5496.00,"discounted_cash":5496.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2473.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2919.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1810.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2177.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2418.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4946.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1225.61,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":824.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4671.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3737.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1648.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1588.34,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL 6X150MM 135CM ","code_information":[{"code":"360650","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5073.00,"discounted_cash":5073.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":963.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":963.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2282.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2694.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1671.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2009.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1247.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1247.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2232.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4565.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1131.28,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4058.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":760.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4058.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4312.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3449.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4058.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1521.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1466.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL 7X100MM 135CM ","code_information":[{"code":"382845","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL 8MM 75X8CM ","code_information":[{"code":"386611","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6976.00,"discounted_cash":6976.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1325.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1325.44,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3139.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3705.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2297.89,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2763.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1716.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1716.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3069.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6278.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1555.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1046.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5929.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4743.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5580.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2092.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2016.06,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL DCB 6X150X150 ","code_information":[{"code":"408912","type":"CDM"},{"code":"C2623","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29199.00,"discounted_cash":29199.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5547.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5547.81,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13139.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15510.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9618.15,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":11568.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7182.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7182.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12847.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26279.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6511.38,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23359.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4379.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23359.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24819.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":19855.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23359.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8759.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8438.51,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNDL PTA 10X20X135 ","code_information":[{"code":"184372","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6342.00,"discounted_cash":6342.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2853.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3368.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2089.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2512.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2790.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5707.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1414.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":951.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5390.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4312.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1902.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1832.84,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNOCC 2.8FR 3X15MM ","code_information":[{"code":"381709","type":"CDM"},{"code":"C2628","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29195.00,"discounted_cash":29195.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5547.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5547.05,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13137.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15508.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9616.83,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":11567.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7181.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7181.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12845.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26275.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6510.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23356.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4379.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23356.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24815.75,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":19852.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23356.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8758.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8437.35,"methodology":"percent of total billed charges"}]}]},{"description":"CATH BLNOCC 9FR 120CM ","code_information":[{"code":"381252","type":"CDM"},{"code":"C2628","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13899.00,"discounted_cash":13899.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2640.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2640.81,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6254.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7383.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4578.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5506.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3419.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3419.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6115.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12509.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3099.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11119.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2084.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11119.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11814.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9451.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11119.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4169.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4016.81,"methodology":"percent of total billed charges"}]}]},{"description":"CATH CLRWY OTW 4.0X10X80 ","code_information":[{"code":"182027","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21852.00,"discounted_cash":21852.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2185.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2185.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2185.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4151.88,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9833.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11607.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7198.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8657.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5375.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9614.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19666.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4873.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29937.24,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3277.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3277.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18574.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14859.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17481.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6555.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14203.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14203.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14203.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6315.23,"methodology":"percent of total billed charges"}]}]},{"description":"CATH COR 3MM 6MM ","code_information":[{"code":"185111","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7399.00,"discounted_cash":7399.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1405.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1405.81,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3329.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3930.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2437.23,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2931.48,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1820.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1820.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3255.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6659.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1649.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5919.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1109.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5919.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6289.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5031.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5919.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2219.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2138.31,"methodology":"percent of total billed charges"}]}]},{"description":"CATH CRICO OPN ARWYGDWR ","code_information":[{"code":"382265","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10090.00,"discounted_cash":10090.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1917.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1009.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1009.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1009.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1917.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4540.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5359.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3323.65,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3997.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2482.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2482.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4439.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9081.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2250.07,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8072.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":13823.30,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1513.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1513.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8072.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8576.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6861.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8072.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3027.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6558.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6558.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6558.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2916.01,"methodology":"percent of total billed charges"}]}]},{"description":"CATH CV 8FR SNGL 4VTCF ","code_information":[{"code":"740955","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7610.00,"discounted_cash":7610.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3424.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4042.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2506.73,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3015.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3348.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6849.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1697.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1141.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6468.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5174.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2283.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2199.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DBC 5X60MM 75CM ","code_information":[{"code":"387136","type":"CDM"},{"code":"C2623","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DCB 10X60MM 75CM ","code_information":[{"code":"381605","type":"CDM"},{"code":"C2623","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29402.00,"discounted_cash":29402.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5586.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5586.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13230.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15618.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9685.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":11649.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7232.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7232.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12936.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26461.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6556.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23521.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4410.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23521.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24991.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":19993.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23521.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8820.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8497.18,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DILAT .018X4X2-135C ","code_information":[{"code":"181738","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8692.00,"discounted_cash":8692.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1651.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1651.48,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3911.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4617.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2863.14,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3443.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2138.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2138.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3824.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7822.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1938.32,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11908.04,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1303.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1303.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7388.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5910.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2607.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2511.99,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DILAT .018X6X6-135C ","code_information":[{"code":"181736","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8692.00,"discounted_cash":8692.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1651.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":869.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1651.48,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3911.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4617.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2863.14,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3443.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2138.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2138.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3824.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7822.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1938.32,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11908.04,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1303.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1303.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7388.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5910.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6953.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2607.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5649.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2511.99,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DILAT GUIDEWR .03 ","code_information":[{"code":"467571","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8653.00,"discounted_cash":8653.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1644.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":865.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":865.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":865.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1644.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3893.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4596.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2850.30,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3428.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2128.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2128.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3807.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7787.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1929.62,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6922.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11854.61,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1297.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1297.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6922.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7355.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5884.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6922.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2595.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5624.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5624.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5624.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2500.72,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DLV SYS 125CM 6FR ","code_information":[{"code":"359387","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5200.00,"discounted_cash":5200.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":988.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":988.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2340.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2762.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1712.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2060.24,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1279.20,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1279.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2288.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4680.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1159.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4160.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":780.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4160.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4420.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3536.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4160.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1560.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1502.80,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DLVR SYS 10F 45/80 ","code_information":[{"code":"360996","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":23710.00,"discounted_cash":23710.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4504.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2371.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2371.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2371.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4504.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10669.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12594.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7810.07,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9393.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5832.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5832.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10432.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21339.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5287.33,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18968.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":32482.70,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3556.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3556.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18968.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20153.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":16122.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18968.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7113.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15411.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15411.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15411.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6852.19,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DLYS 15FR 62.5CM ","code_information":[{"code":"184823","type":"CDM"},{"code":"C1750","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6136.00,"discounted_cash":6136.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1165.84,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1165.84,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2761.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3259.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2021.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2431.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1509.46,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1509.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2699.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5522.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1368.33,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4908.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":920.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4908.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5215.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4172.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4908.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1840.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1773.30,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DRN 10FR 25CM 8HL ","code_information":[{"code":"386229","type":"CDM"},{"code":"C1729","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2954.00,"discounted_cash":2954.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":561.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":561.26,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1329.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1569.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":973.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1170.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":726.68,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":726.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1299.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2658.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":658.74,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2363.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":443.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2510.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2008.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2363.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":886.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":853.71,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DRN 5FR 10CM ","code_information":[{"code":"387063","type":"CDM"},{"code":"C1729","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2082.00,"discounted_cash":2082.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":395.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":395.58,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":936.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1105.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":685.81,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":824.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":512.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":512.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":916.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1873.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":464.29,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1665.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":312.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1665.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1769.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1415.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1665.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":624.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":601.70,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DRN APD REG 12F 35 ","code_information":[{"code":"351879","type":"CDM"},{"code":"C1729","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4096.00,"discounted_cash":4096.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":778.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":778.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1843.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2175.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1349.22,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1622.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1007.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1007.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1802.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3686.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":913.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3276.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":614.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3276.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3481.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2785.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3276.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1228.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1183.74,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DRN MLCT 30F 4WNG ","code_information":[{"code":"10497","type":"CDM"},{"code":"C1729","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":854.00,"discounted_cash":854.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":162.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":162.26,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":384.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":453.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":281.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":338.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":210.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":210.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":375.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":768.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":190.44,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":683.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":683.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":725.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":580.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":683.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":256.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":246.81,"methodology":"percent of total billed charges"}]}]},{"description":"CATH DRN THOR 32FR 23IN ","code_information":[{"code":"361021","type":"CDM"},{"code":"C1729","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":520.00,"discounted_cash":520.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":98.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":98.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":234.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":276.22,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":171.29,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":206.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":127.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":127.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":228.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":468.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":115.96,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":416.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":78.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":416.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":442.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":353.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":416.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":156.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":150.28,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EA ADDL LOW ART ","code_information":[{"code":"461248","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3327.50,"discounted_cash":3327.50,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1497.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1318.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":818.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":818.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1464.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2994.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":742.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2662.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4558.68,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":499.13,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":499.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2662.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2828.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":961.65,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EMERGE MR 30X3.50MM ","code_information":[{"code":"468603","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5285.00,"discounted_cash":5285.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1004.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2378.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2807.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1740.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2093.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1300.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2325.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4756.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1178.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":792.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4492.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3593.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4228.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1585.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1527.37,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 1086259RT ","code_information":[{"code":"359141","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7948.00,"discounted_cash":7948.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1510.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1510.12,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3576.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4221.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2618.07,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3149.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1955.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1955.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3497.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7153.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1772.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6358.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1192.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6358.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6755.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5404.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6358.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2384.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2296.97,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 3.3FR 165CM ","code_information":[{"code":"22173","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20487.00,"discounted_cash":20487.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3892.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3892.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9219.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10882.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6748.42,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8116.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5039.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5039.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9014.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18438.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4568.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3073.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17413.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13931.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6146.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5920.74,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 6FR 60CM ","code_information":[{"code":"467457","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 7FR 110CM ","code_information":[{"code":"468452","type":"CDM"},{"code":"C1731","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 7FR 115CM ","code_information":[{"code":"468454","type":"CDM"},{"code":"C2630","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21361.00,"discounted_cash":21361.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4058.59,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4058.59,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9612.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11346.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7036.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8463.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5254.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5254.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9398.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19224.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4763.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17088.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3204.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17088.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18156.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14525.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17088.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6408.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6173.33,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP 8FR 125CM ","code_information":[{"code":"467491","type":"CDM"},{"code":"C1732","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15244.00,"discounted_cash":15244.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6859.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8097.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5021.37,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6039.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6707.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13719.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3399.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2286.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12957.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10365.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4573.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4405.52,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP C CRV 5X120 6FR ","code_information":[{"code":"467451","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP DYN 6FR 125CM ","code_information":[{"code":"467459","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11704.00,"discounted_cash":11704.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2223.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2223.76,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5266.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6217.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3855.30,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4637.12,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2879.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2879.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5149.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10533.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2609.99,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1755.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9948.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7958.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3511.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3382.46,"methodology":"percent of total billed charges"}]}]},{"description":"CATH EP120/7FR DECA RE ","code_information":[{"code":"467151","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1602.00,"discounted_cash":1602.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":304.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":304.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":720.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":850.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":527.70,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":634.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":394.09,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":394.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":704.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1441.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":357.25,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1281.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2194.74,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":240.30,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":240.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1281.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1361.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1089.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1281.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":480.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1041.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1041.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1041.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":462.98,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FOLEY 26FR 30CC 3W ","code_information":[{"code":"357887","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":859.00,"discounted_cash":859.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":456.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":282.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":340.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":377.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1176.83,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":584.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":257.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.25,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FOLEY 2W 18FR 5CC ","code_information":[{"code":"21947","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":599.00,"discounted_cash":599.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":113.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":59.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":59.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":59.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":113.81,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":269.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":318.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":197.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":237.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":147.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":147.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":263.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":539.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":133.58,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":479.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":820.63,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":89.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":89.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":479.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":509.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":407.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":479.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":179.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":389.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":389.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":389.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":173.11,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FOLEY 2W 24FR 30CC ","code_information":[{"code":"352586","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":174.00,"discounted_cash":174.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":33.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":17.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":17.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":17.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":33.06,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":78.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":92.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":57.32,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":68.94,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":42.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":42.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":76.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":156.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":38.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":139.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":238.38,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":26.10,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":26.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":139.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":147.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":118.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":139.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":52.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":113.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":113.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":113.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":50.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FOLEY PED 8FR 3CC ","code_information":[{"code":"385225","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":469.00,"discounted_cash":469.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":89.11,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":46.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":46.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":46.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":89.11,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":211.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":249.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":154.49,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":185.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":115.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":115.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":206.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":422.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":104.59,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":642.53,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":70.35,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":70.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":398.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":318.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":140.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":304.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":304.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":304.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":135.54,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FXCRS PTA 4X60X135 ","code_information":[{"code":"184342","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6342.00,"discounted_cash":6342.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2853.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3368.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2089.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2512.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2790.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5707.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1414.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":951.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5390.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4312.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1902.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1832.84,"methodology":"percent of total billed charges"}]}]},{"description":"CATH FXCRS PTA 7X30X135 ","code_information":[{"code":"184361","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6342.00,"discounted_cash":6342.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1204.98,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2853.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3368.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2089.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2512.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1560.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2790.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5707.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1414.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":951.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5390.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4312.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5073.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1902.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1832.84,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 1.5FR 150CM ","code_information":[{"code":"467300","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10331.00,"discounted_cash":10331.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1962.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1962.89,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4648.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5487.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3403.03,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4093.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2541.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2541.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4545.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9297.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2303.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8264.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1549.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8264.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8781.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7025.08,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8264.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3099.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2985.66,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 2.5FR 150CM ","code_information":[{"code":"429401","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14265.00,"discounted_cash":14265.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2710.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2710.35,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6419.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7577.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4698.89,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5651.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3509.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3509.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6276.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12838.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3181.09,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11412.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2139.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11412.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12125.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9700.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11412.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4279.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4122.59,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 3.8FR 125CM ","code_information":[{"code":"920860","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 50CM 6FR .068IN ","code_information":[{"code":"467827","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3090.00,"discounted_cash":3090.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":587.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":587.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1390.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1641.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1017.85,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1224.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":760.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":760.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2781.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":689.07,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":463.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2626.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2101.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":927.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":893.01,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 50CM 9FR ","code_information":[{"code":"22571","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7610.00,"discounted_cash":7610.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3424.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4042.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2506.73,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3015.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3348.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6849.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1697.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1141.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6468.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5174.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2283.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2199.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 6F RDC 55CM ","code_information":[{"code":"436538","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2230.00,"discounted_cash":2230.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":423.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":423.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1003.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1184.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":734.56,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":883.53,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":548.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":548.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":981.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2007.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":497.29,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":334.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":669.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":644.47,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 6FR 100CM ","code_information":[{"code":"182888","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 6FR 100CM ","code_information":[{"code":"434294","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2063.00,"discounted_cash":2063.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":928.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1095.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":679.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":817.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":907.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1856.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":460.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":309.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1753.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1402.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":618.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":596.21,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 6FR 100CM F5 ","code_information":[{"code":"413635","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2063.00,"discounted_cash":2063.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":928.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1095.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":679.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":817.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":907.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1856.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":460.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":309.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1753.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1402.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":618.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":596.21,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 6FR 55CM M1 RDC1 ","code_information":[{"code":"358667","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3876.00,"discounted_cash":3876.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":736.44,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":736.44,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1744.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2058.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1276.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1535.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":953.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":953.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1705.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3488.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":864.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3100.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":581.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3100.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3294.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2635.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3100.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1162.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1120.16,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 7FR 70CM ","code_information":[{"code":"22205","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7187.00,"discounted_cash":7187.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1365.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1365.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3234.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3817.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2367.40,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2847.49,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1768.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1768.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3162.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6468.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1602.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5749.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1078.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5749.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6108.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4887.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5749.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2156.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2077.04,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 8FR 100CM ","code_information":[{"code":"407953","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD 9FR 45CM ","code_information":[{"code":"361043","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10442.00,"discounted_cash":10442.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1983.98,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1983.98,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4698.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5546.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3439.59,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4137.12,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2568.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2568.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4594.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9397.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2328.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8353.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1566.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8353.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8875.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7100.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8353.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3132.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3017.74,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD AL.75 7FR 100CM ","code_information":[{"code":"468506","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD AL1.5 7FR 100CM ","code_information":[{"code":"468509","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD AL2.5 7FR 100CM ","code_information":[{"code":"468512","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD ALR1 6FR 100CM ","code_information":[{"code":"11923","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD ALR2 7FR 100CM ","code_information":[{"code":"468518","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD CHMP4 6FR 100CM ","code_information":[{"code":"382042","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD EBU3 7FR 100CM ","code_information":[{"code":"468520","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD EBU4 7FR 100CM ","code_information":[{"code":"468527","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD EBU5 7FR 100CM ","code_information":[{"code":"468529","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD HSI 7FR 100CM ","code_information":[{"code":"468530","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD HSIII 7FR 100CM ","code_information":[{"code":"382080","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD IMA 7FR 90CM ","code_information":[{"code":"182295","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD JCR5 6FR 100CM ","code_information":[{"code":"381852","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD LCB 7FR 90CM ","code_information":[{"code":"382152","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD MAC4.5 6FR 100CM ","code_information":[{"code":"381903","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD MB2 6FR 100CM ","code_information":[{"code":"355970","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD MPD 7FR 100CM ","code_information":[{"code":"359370","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13030.00,"discounted_cash":13030.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2475.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2475.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5863.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6921.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4292.08,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5162.49,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3205.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3205.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5733.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11727.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2905.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10424.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1954.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11075.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":8860.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10424.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3909.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3765.67,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD RBU3.5 6FR 100CM ","code_information":[{"code":"182302","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD RCB 7FR 100CM ","code_information":[{"code":"468553","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SAL1.5 7FR 100CM ","code_information":[{"code":"381994","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SAR1 6FR 100CM ","code_information":[{"code":"382044","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SAR4 6FR 100CM ","code_information":[{"code":"468504","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SL3 7FR 100CM ","code_information":[{"code":"381998","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SL5 6FR 100CM ","code_information":[{"code":"382032","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD SR3.5 7FR 100CM ","code_information":[{"code":"381996","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STD 6FR 100CM ","code_information":[{"code":"182075","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2408.00,"discounted_cash":2408.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":457.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":457.52,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1083.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1279.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":793.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":954.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":592.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":592.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1059.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":536.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":361.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2046.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1637.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":722.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":695.91,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STD 7FR 100CM ","code_information":[{"code":"381863","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJCR 7FR 100CM ","code_information":[{"code":"182297","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJL4 6FR 100CM ","code_information":[{"code":"468495","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJL6 7FR 100CM ","code_information":[{"code":"381991","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2453.00,"discounted_cash":2453.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":466.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1103.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1303.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":808.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":971.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":603.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1079.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2207.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":547.02,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":367.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2085.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1668.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1962.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":735.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":708.92,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJLC 7FR 100CM ","code_information":[{"code":"382081","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2509.00,"discounted_cash":2509.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":476.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":994.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":617.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1103.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2258.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":559.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":376.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2132.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1706.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2007.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":725.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJR3 6FR 100CM ","code_information":[{"code":"468119","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD STDJR5 6FR 100CM ","code_information":[{"code":"382041","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2341.00,"discounted_cash":2341.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":444.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1053.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1243.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":771.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":927.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":575.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1030.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2106.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":522.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":351.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1989.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1591.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1872.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":702.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":676.55,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GD VASC.058IN 115CM ","code_information":[{"code":"359351","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":40318.00,"discounted_cash":40318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7660.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7660.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18143.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":21416.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":13280.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":15973.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9918.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9918.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":17739.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":36286.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8990.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32254.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6047.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32254.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34270.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":27416.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32254.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":12095.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11651.90,"methodology":"percent of total billed charges"}]}]},{"description":"CATH GLD 5F STR XP ","code_information":[{"code":"468945","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2787.00,"discounted_cash":2787.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":529.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1254.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1480.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":918.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1104.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":685.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1226.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2508.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":621.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":418.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2368.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1895.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2229.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":836.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":805.44,"methodology":"percent of total billed charges"}]}]},{"description":"CATH HEADHNTR 5FRX100 ","code_information":[{"code":"279764","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":859.00,"discounted_cash":859.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":456.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":282.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":340.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":377.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1176.83,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":584.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":257.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.25,"methodology":"percent of total billed charges"}]}]},{"description":"CATH HMD 33FR 50CM ","code_information":[{"code":"428180","type":"CDM"},{"code":"C1752","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9005.00,"discounted_cash":9005.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1710.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1710.95,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4052.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4783.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2966.25,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3567.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2215.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2215.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3962.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8104.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2008.12,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7204.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1350.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7204.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7654.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6123.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7204.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2701.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2602.45,"methodology":"percent of total billed charges"}]}]},{"description":"CATH HRT LT/INJ L VENT ","code_information":[{"code":"463452","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":46323.00,"discounted_cash":46323.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4632.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4632.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4632.30,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20845.35,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":18353.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":20382.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41690.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":10330.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37058.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":63462.51,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6948.45,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6948.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37058.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":39374.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":31499.64,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30109.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30109.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30109.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13387.35,"methodology":"percent of total billed charges"}]}]},{"description":"CATH IAB 7FR 258MM ","code_information":[{"code":"182838","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":23995.00,"discounted_cash":23995.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4559.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2399.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2399.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2399.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4559.05,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10797.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12746.14,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7903.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9506.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5902.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5902.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10557.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21595.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5350.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19196.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":32873.15,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3599.25,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3599.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19196.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20395.75,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":16316.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19196.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7198.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15596.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15596.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15596.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6934.56,"methodology":"percent of total billed charges"}]}]},{"description":"CATH IMAGING 2.5FR 142CM ","code_information":[{"code":"358797","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":18575.00,"discounted_cash":18575.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3529.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1857.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1857.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1857.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3529.25,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8358.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9867.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6118.60,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":7359.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4569.45,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4569.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":8173.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16717.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4142.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14860.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":25447.75,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2786.25,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2786.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14860.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15788.75,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":12631.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14860.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5572.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12073.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12073.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12073.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5368.18,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INFS 1.2MM 160CM ","code_information":[{"code":"386665","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":22727.00,"discounted_cash":22727.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4318.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2272.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2272.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2272.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4318.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10227.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12072.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7486.27,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9004.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5590.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5590.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9999.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20454.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5068.12,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18181.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":31135.99,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3409.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3409.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18181.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19317.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":15454.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18181.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6818.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14772.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14772.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14772.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6568.10,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INFS 5FR 100CM ","code_information":[{"code":"388037","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5454.00,"discounted_cash":5454.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1036.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1036.26,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2454.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2897.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1796.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2160.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1341.68,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1341.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2399.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4908.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1216.24,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4363.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":818.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4635.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3708.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4363.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1636.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1576.21,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INFS 5FR 65CM ","code_information":[{"code":"386286","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INFS PRWLR 10F 150 ","code_information":[{"code":"357485","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25321.00,"discounted_cash":25321.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4810.99,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4810.99,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11394.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13450.52,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8340.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10032.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6228.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6228.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":11141.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22788.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5646.58,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20256.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3798.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20256.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21522.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":17218.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20256.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7596.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7317.77,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INTHCL 4FR 140CM ","code_information":[{"code":"388565","type":"CDM"},{"code":"C1755","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13295.00,"discounted_cash":13295.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5982.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7062.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4379.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11965.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11300.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3842.26,"methodology":"percent of total billed charges"}]}]},{"description":"CATH INTRO 4F 21G 11X4CM ","code_information":[{"code":"423030","type":"CDM"},{"code":"C1894","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3287.00,"discounted_cash":3287.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":624.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":624.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1479.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1746.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1082.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1302.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":808.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":808.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1446.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2958.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":733.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2629.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":493.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2629.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2793.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2235.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2629.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":986.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":949.94,"methodology":"percent of total billed charges"}]}]},{"description":"CATH IV STYL XTN VPSG4SC ","code_information":[{"code":"387438","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":226.00,"discounted_cash":226.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":42.94,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":42.94,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":101.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":120.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":74.44,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":89.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":55.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":55.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":99.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":203.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":50.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":180.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":309.62,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":33.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":33.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":180.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":192.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":153.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":180.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":67.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":146.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":146.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":146.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":65.31,"methodology":"percent of total billed charges"}]}]},{"description":"CATH J CRVD 2.0FR 150CM ","code_information":[{"code":"915114","type":"CDM"},{"code":"C1757","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20794.00,"discounted_cash":20794.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3950.86,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3950.86,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9357.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11045.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6849.54,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8238.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5115.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5115.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9149.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18714.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4637.06,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16635.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3119.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16635.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17674.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14139.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16635.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6238.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6009.47,"methodology":"percent of total billed charges"}]}]},{"description":"CATH LG CRSNT 4MM 150CM ","code_information":[{"code":"467618","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9301.00,"discounted_cash":9301.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1767.19,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1767.19,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4185.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4940.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3063.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3685.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2288.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2288.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4092.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8370.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2074.12,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1395.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7905.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6324.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2790.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2687.99,"methodology":"percent of total billed charges"}]}]},{"description":"CATH LG CRSNT LOPRO 3MM ","code_information":[{"code":"467718","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5496.00,"discounted_cash":5496.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2473.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2919.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1810.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2177.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2418.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4946.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1225.61,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":824.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4671.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3737.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1648.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1588.34,"methodology":"percent of total billed charges"}]}]},{"description":"CATH LG CRSNT LOPRO 5MM ","code_information":[{"code":"467724","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5496.00,"discounted_cash":5496.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2473.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2919.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1810.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2177.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2418.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4946.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1225.61,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":824.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4671.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3737.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1648.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1588.34,"methodology":"percent of total billed charges"}]}]},{"description":"CATH LG CRSNT LOPRO 8MM ","code_information":[{"code":"467698","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5496.00,"discounted_cash":5496.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1044.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2473.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2919.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1810.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2177.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1352.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2418.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4946.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1225.61,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":824.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4671.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3737.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4396.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1648.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1588.34,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER EP 115CM 6FR ","code_information":[{"code":"350656","type":"CDM"},{"code":"C1730","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3072.00,"discounted_cash":3072.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":583.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":583.68,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1382.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1631.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1011.92,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1217.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":755.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":755.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1351.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2764.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":685.06,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2457.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2457.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2611.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2088.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2457.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":921.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":887.81,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER GD 100CM 6FR LG ","code_information":[{"code":"359369","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12451.00,"discounted_cash":12451.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2365.69,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2365.69,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5602.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6613.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4101.36,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4933.09,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3062.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3062.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5478.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11205.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2776.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1867.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10583.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":8466.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3735.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3598.34,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER GD CTLST 132CM ","code_information":[{"code":"387566","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30781.00,"discounted_cash":30781.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5848.39,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5848.39,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13851.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16350.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10139.26,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12195.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7572.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7572.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13543.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27702.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6864.16,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24624.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4617.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24624.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26163.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":20931.08,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24624.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9234.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8895.71,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER INFS MIC 2.8-3F ","code_information":[{"code":"380129","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21743.00,"discounted_cash":21743.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4131.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4131.17,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9784.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11549.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7162.14,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8614.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5348.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5348.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9566.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19568.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4848.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17394.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3261.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17394.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18481.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14785.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17394.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6522.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6283.73,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER S TIP 7FR 110CM ","code_information":[{"code":"468630","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3729.00,"discounted_cash":3729.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":708.51,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":372.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":372.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":372.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":708.51,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1678.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1980.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1228.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1477.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":917.33,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":917.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1640.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3356.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":831.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2983.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5108.73,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":559.35,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":559.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2983.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3169.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2535.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2983.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1118.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2423.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2423.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2423.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1077.68,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER ULTSND 8FR 90CM ","code_information":[{"code":"356410","type":"CDM"},{"code":"C1753","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25018.00,"discounted_cash":25018.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4753.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4753.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11258.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13289.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8240.93,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9912.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6154.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6154.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":11007.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22516.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5579.01,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20014.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3752.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20014.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21265.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":17012.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20014.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7505.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7230.20,"methodology":"percent of total billed charges"}]}]},{"description":"CATHETER XPRESS-WAY 6 FR ","code_information":[{"code":"350975","type":"CDM"},{"code":"C1757","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16389.00,"discounted_cash":16389.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3113.91,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3113.91,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7375.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8705.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5398.54,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6493.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4031.69,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4031.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7211.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14750.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3654.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13111.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2458.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13111.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13930.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":11144.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13111.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4916.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4736.42,"methodology":"percent of total billed charges"}]}]},{"description":"CATHGD VBT 8FR JR3.5 100 ","code_information":[{"code":"182912","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CB INTERST APP COMP ","code_information":[{"code":"727018","type":"CDM"},{"code":"77778","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4010.75,"discounted_cash":4010.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":762.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":762.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1804.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1764.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3609.68,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":894.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3208.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":601.61,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3208.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3409.14,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2727.31,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3208.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1159.11,"methodology":"percent of total billed charges"}]}]},{"description":"CEA ","code_information":[{"code":"372622","type":"CDM"},{"code":"82378","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":14.50,"discounted_cash":14.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13.05,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12.32,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9.86,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4.19,"methodology":"percent of total billed charges"}]}]},{"description":"CEFAZOLIN 500 MG INJ ","drug_information":{"unit":"500","type":"ME"},"code_information":[{"code":"125345","type":"CDM"},{"code":"J0690","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":42.00,"discounted_cash":42.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":18.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":37.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12.14,"methodology":"percent of total billed charges"}]}]},{"description":"CEFIDEROCOL 10 MG INJ ","drug_information":{"unit":"10","type":"ME"},"code_information":[{"code":"128363","type":"CDM"},{"code":"J0699","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16.75,"discounted_cash":16.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15.07,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4.84,"methodology":"percent of total billed charges"}]}]},{"description":"CEFOXITIN 1 G INJ ","drug_information":{"unit":"1","type":"GM"},"code_information":[{"code":"125460","type":"CDM"},{"code":"J0694","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":144.25,"discounted_cash":144.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":64.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":63.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":129.82,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":115.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":21.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":115.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":122.61,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":115.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":41.69,"methodology":"percent of total billed charges"}]}]},{"description":"CEFTAZ/AVIBCT 2.5 G INJ ","drug_information":{"unit":"2.5","type":"GM"},"code_information":[{"code":"126745","type":"CDM"},{"code":"J0714","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3438.25,"discounted_cash":3438.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1547.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1512.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3094.43,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2750.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":515.74,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2750.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2922.51,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2750.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":993.65,"methodology":"percent of total billed charges"}]}]},{"description":"CEFTOLOZ TAZOBACT 1.5 G ","drug_information":{"unit":"1.5","type":"GM"},"code_information":[{"code":"126796","type":"CDM"},{"code":"J0695","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1096.25,"discounted_cash":1096.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":493.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":482.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":986.63,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":877.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":164.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":877.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":931.81,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":877.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":316.82,"methodology":"percent of total billed charges"}]}]},{"description":"CEFTZ/AVBCT 0.625G INJJW ","drug_information":{"unit":"0.625","type":"GM"},"code_information":[{"code":"126935","type":"CDM"},{"code":"J0714","type":"HCPCS"}],"standard_charges":[{"modifiers":"JW","modifiers_description":"Drug amount discarded/not administered to any patient","setting":"outpatient","gross_charge":859.50,"discounted_cash":859.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":378.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.55,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.58,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.40,"methodology":"percent of total billed charges"}]}]},{"description":"CELECOXIB 100MG CAP ","code_information":[{"code":"120295","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":32.75,"discounted_cash":32.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":17.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10.79,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":14.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":29.48,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":44.87,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.91,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27.84,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":22.27,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9.82,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9.46,"methodology":"percent of total billed charges"}]}]},{"description":"CELLULITIS WITHOUT MCC ","code_information":[{"code":"603","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":17098.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":10992.90,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":13565.61,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":8973.79,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11441.58,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":16927.02,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":7852.07,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":17098.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":15816.31,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":10992.90,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11778.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11217.24,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":17098.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":17098.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11217.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":7852.07,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":7852.07,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":7852.07,"methodology":"fee schedule"}]}]},{"description":"CEMENT BN CA PHS HA 15CC ","code_information":[{"code":"387069","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":48803.00,"discounted_cash":48803.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4880.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4880.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4880.30,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21961.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":25924.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16075.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":43922.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39042.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":66860.11,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39042.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":41482.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39042.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31721.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31721.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31721.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14104.07,"methodology":"percent of total billed charges"}]}]},{"description":"CEMENT BN INJ PMMA 10ML ","code_information":[{"code":"389771","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"CEMENT BN PMMA 40GM ","code_information":[{"code":"175118","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":947.00,"discounted_cash":947.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":94.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":94.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":94.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":426.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":503.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":311.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":852.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":757.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1297.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":757.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":804.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":757.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":615.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":615.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":615.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":273.68,"methodology":"percent of total billed charges"}]}]},{"description":"CEMENT BN PMMA GNTA 40GM ","code_information":[{"code":"23675","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4391.00,"discounted_cash":4391.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1975.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2332.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1446.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3951.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":6015.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3732.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1269.00,"methodology":"percent of total billed charges"}]}]},{"description":"CEMENT BN W-MXR ","code_information":[{"code":"384742","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6876.00,"discounted_cash":6876.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":687.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3094.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3652.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2264.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6188.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5500.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9420.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5500.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5844.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5500.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4469.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4469.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4469.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1987.16,"methodology":"percent of total billed charges"}]}]},{"description":"CENTRALIZER DISTAL 12MM ","code_information":[{"code":"25666","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1452.00,"discounted_cash":1452.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":653.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":771.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":478.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1306.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1234.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1161.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":419.63,"methodology":"percent of total billed charges"}]}]},{"description":"CENTRALIZR STM HIP 8.5MM ","code_information":[{"code":"25890","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1749.00,"discounted_cash":1749.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":787.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":929.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":576.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1574.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1399.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1399.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1486.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1399.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":505.46,"methodology":"percent of total billed charges"}]}]},{"description":"CERULOPLASMIN ","code_information":[{"code":"370265","type":"CDM"},{"code":"82390","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4.69,"discounted_cash":4.69,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.89,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4.22,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.99,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.36,"methodology":"percent of total billed charges"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC ","code_information":[{"code":"785","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1363.00,"maximum":16742.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":9226.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":9226.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":10923.94,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":8300.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":8917.50,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11369.82,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_dollar":3654.00,"methodology":"per diem"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":3654.00,"methodology":"per diem"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":16574.58,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":7802.82,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":2838.00,"methodology":"per diem","additional_payer_notes":"Days 0 - 1. "},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":16742.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":10923.94,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":11704.22,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11146.88,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":16742.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":4839.00,"methodology":"per diem","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":16742.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11146.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":7802.82,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":7802.82,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":7802.82,"methodology":"fee schedule"}]}]},{"description":"CETUXIMAB 100 MG INJ ","drug_information":{"unit":"100","type":"ME"},"code_information":[{"code":"125537","type":"CDM"},{"code":"J9055","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6739.00,"discounted_cash":6739.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3032.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2965.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6065.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5391.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1010.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5391.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5728.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5391.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1947.57,"methodology":"percent of total billed charges"}]}]},{"description":"CG SPNL 14X12X9 COALITIO ","code_information":[{"code":"175254","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":38495.00,"discounted_cash":38495.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17322.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20448.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12680.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":34645.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":52738.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32720.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11125.06,"methodology":"percent of total billed charges"}]}]},{"description":"CHARGER NRSTM PT 97754 ","code_information":[{"code":"354759","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":30416.00,"discounted_cash":30416.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5779.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3041.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3041.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3041.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5779.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13687.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16156.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10019.03,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12050.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7482.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7482.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13383.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27374.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6782.77,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24332.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":41669.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4562.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4562.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24332.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25853.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":20682.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24332.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9124.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19770.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19770.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19770.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8790.22,"methodology":"percent of total billed charges"}]}]},{"description":"CHEMO IV EA ADD HOUR ","code_information":[{"code":"23180","type":"CDM"},{"code":"96415","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1614.25,"discounted_cash":1614.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":306.71,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":306.71,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":726.41,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":639.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":710.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1452.83,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":359.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1291.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":242.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1291.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1372.11,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1097.69,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1291.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":466.52,"methodology":"percent of total billed charges"}]}]},{"description":"CHEST PAIN ","code_information":[{"code":"313","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":13985.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":9066.72,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":11128.79,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":7401.40,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9436.79,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":13845.15,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":6476.23,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":13985.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":13044.97,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":9066.72,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":9714.34,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":9251.75,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":13985.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":13985.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":9251.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":10559.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":6476.23,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":6476.23,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":6476.23,"methodology":"fee schedule"}]}]},{"description":"CHEST XRAY 4+ ","code_information":[{"code":"71048","type":"CPT"},{"code":"721048","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1785.25,"discounted_cash":1785.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":339.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":339.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":803.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":785.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1606.72,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":398.11,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1428.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":267.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1428.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1517.46,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1213.97,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1428.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":535.58,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":515.94,"methodology":"percent of total billed charges"}]}]},{"description":"CHLAMYDIA & GC DIR PROBE ","code_information":[{"code":"370270","type":"CDM"},{"code":"87800","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":24.00,"discounted_cash":24.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.56,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":16.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6.94,"methodology":"percent of total billed charges"}]}]},{"description":"CHLAMYDIA PNEUMO IGG ","code_information":[{"code":"372592","type":"CDM"},{"code":"86631","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":50.00,"discounted_cash":50.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":11.15,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":34.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"}]}]},{"description":"CHLAMYDIA T AMP PROBE ","code_information":[{"code":"372586","type":"CDM"},{"code":"87491","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":17.50,"discounted_cash":17.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.33,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.88,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":11.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5.06,"methodology":"percent of total billed charges"}]}]},{"description":"CHLECYSTOSTMY PERC ","code_information":[{"code":"277490","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15826.75,"discounted_cash":15826.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1582.67,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1582.67,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1582.67,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7122.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6270.56,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3893.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3893.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6963.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14244.08,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3529.37,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12661.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21682.65,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2374.01,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2374.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12661.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13452.74,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10287.39,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10287.39,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10287.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4573.93,"methodology":"percent of total billed charges"}]}]},{"description":"CHLORIDE UR ","code_information":[{"code":"363365","type":"CDM"},{"code":"82436","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":388.00,"discounted_cash":388.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":73.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":73.72,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":174.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":170.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":349.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":86.52,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":310.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":58.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":310.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":329.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":263.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":310.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":112.13,"methodology":"percent of total billed charges"}]}]},{"description":"CHLORPHENIRAMINE 4MG TAB ","code_information":[{"code":"120087","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1.00,"discounted_cash":1.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.19,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.19,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":0.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":0.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":0.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":0.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":0.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":0.22,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.15,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":0.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":0.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":0.29,"methodology":"percent of total billed charges"}]}]},{"description":"CHOLECALCIFEROL 400U TAB ","code_information":[{"code":"21491","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6.75,"discounted_cash":6.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.28,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2.22,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6.08,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9.25,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5.74,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4.59,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2.02,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4.39,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4.39,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4.39,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"}]}]},{"description":"CHOLINESTERASE RBC ","code_information":[{"code":"370325","type":"CDM"},{"code":"82482","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":7.74,"discounted_cash":7.74,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6.97,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.73,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.19,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.58,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5.26,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.19,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.24,"methodology":"percent of total billed charges"}]}]},{"description":"CHROM COUNT 5 KARY W BND ","code_information":[{"code":"368785","type":"CDM"},{"code":"88261","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":569.75,"discounted_cash":569.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":108.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":108.25,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":256.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":250.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":512.77,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":127.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":455.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":85.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":455.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":484.29,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":387.43,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":455.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":164.66,"methodology":"percent of total billed charges"}]}]},{"description":"CILASTATN/IMIPINM 500 MG ","drug_information":{"unit":"500","type":"ME"},"code_information":[{"code":"125436","type":"CDM"},{"code":"J0743","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":695.50,"discounted_cash":695.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":312.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":306.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":625.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":556.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":104.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":556.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":591.17,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":556.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":201.00,"methodology":"percent of total billed charges"}]}]},{"description":"CIPROFLOXAC 750MG TAB ","code_information":[{"code":"120816","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":67.75,"discounted_cash":67.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":30.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":35.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":22.32,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":26.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":16.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":16.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":29.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":60.98,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":15.11,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":54.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":92.82,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":10.16,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":10.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":54.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":57.59,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":46.07,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":54.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":20.32,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":44.04,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":44.04,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":44.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":19.58,"methodology":"percent of total billed charges"}]}]},{"description":"CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC ","code_information":[{"code":"434","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":12939.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":8872.49,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":9656.54,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":7242.85,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9234.63,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":12809.61,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":6337.49,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":12939.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":12765.52,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":8872.49,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":9506.24,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":9053.56,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":12939.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":12939.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":9053.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":6337.49,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":6337.49,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":6337.49,"methodology":"fee schedule"}]}]},{"description":"CITRATE ","code_information":[{"code":"372030","type":"CDM"},{"code":"82507","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":66.00,"discounted_cash":66.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":29.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":29.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":59.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":14.72,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":9.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":44.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":19.07,"methodology":"percent of total billed charges"}]}]},{"description":"CLADRIBINE 10 MG INJ ","drug_information":{"unit":"10","type":"ME"},"code_information":[{"code":"126727","type":"CDM"},{"code":"J9065","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4575.25,"discounted_cash":4575.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2058.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2013.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4117.73,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3660.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":686.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3660.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3888.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3660.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1322.25,"methodology":"percent of total billed charges"}]}]},{"description":"CLAMP EX FIX 5HL ","code_information":[{"code":"385956","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19531.00,"discounted_cash":19531.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3710.89,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1953.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1953.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1953.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3710.89,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8788.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10374.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6433.51,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":7738.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4804.63,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4804.63,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":8593.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17577.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4355.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15624.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":26757.47,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2929.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2929.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15624.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16601.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13281.08,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15624.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5859.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12695.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12695.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12695.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5644.46,"methodology":"percent of total billed charges"}]}]},{"description":"CLAMP EXFIX F/1.6 KWIRE ","code_information":[{"code":"354253","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17018.00,"discounted_cash":17018.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3233.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1701.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1701.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1701.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3233.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7658.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9039.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5605.73,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6742.53,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4186.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4186.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7487.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15316.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3795.01,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13614.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":23314.66,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2552.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2552.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13614.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14465.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":11572.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13614.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5105.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11061.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11061.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11061.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4918.20,"methodology":"percent of total billed charges"}]}]},{"description":"CLAMP EXFX DNFX VSN 3HL ","code_information":[{"code":"352459","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14112.00,"discounted_cash":14112.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2681.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1411.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1411.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1411.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2681.28,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6350.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7496.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4648.49,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5591.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3471.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3471.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6209.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12700.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3146.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11289.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":19333.44,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11289.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11995.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9596.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11289.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4233.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9172.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9172.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9172.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4078.37,"methodology":"percent of total billed charges"}]}]},{"description":"CLAMP QC EXFX 10.5X10.5 ","code_information":[{"code":"359423","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15244.00,"discounted_cash":15244.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6859.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8097.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5021.37,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6039.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6707.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13719.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3399.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":20884.28,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2286.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2286.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12957.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10365.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4573.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4405.52,"methodology":"percent of total billed charges"}]}]},{"description":"CLAMP UNIV 6 POSITION ","code_information":[{"code":"20295","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15144.00,"discounted_cash":15144.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2877.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1514.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1514.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1514.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2877.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6814.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8044.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4988.43,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6000.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3725.42,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3725.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6663.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13629.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3377.11,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12115.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":20747.28,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2271.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2271.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12115.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12872.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10297.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12115.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4543.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9843.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9843.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9843.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4376.62,"methodology":"percent of total billed charges"}]}]},{"description":"CLINDA 1% TOP SOL 60ML ","code_information":[{"code":"127061","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":93.25,"discounted_cash":93.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":17.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":17.72,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":41.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":49.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":30.72,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":36.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":22.94,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":22.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":41.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":83.92,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":20.79,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":74.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":127.75,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":13.99,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":13.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":74.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":79.26,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":63.41,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":74.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":27.98,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":60.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":60.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":60.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":26.95,"methodology":"percent of total billed charges"}]}]},{"description":"CLINDAMYCIN 75 MG OS ","code_information":[{"code":"126866","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":23.50,"discounted_cash":23.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.46,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21.15,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5.24,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":32.20,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.52,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19.98,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":15.98,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15.28,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15.28,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15.28,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP ANRSM PERM 10.2MM ","code_information":[{"code":"354363","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP ANRSM PERM 3MM ","code_information":[{"code":"354339","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP ANRSM PERM 5MM ","code_information":[{"code":"382065","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP ANRSM PERM 7MM ","code_information":[{"code":"359976","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP EXFIX DYNAMIZATION ","code_information":[{"code":"382583","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP LIGATING LG ","code_information":[{"code":"26059","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1254.00,"discounted_cash":1254.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":125.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":125.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":125.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":564.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":666.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":413.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1128.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1003.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1717.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1003.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1065.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1003.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":815.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":815.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":815.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":362.41,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP LIGATION LARGE ","code_information":[{"code":"354627","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":547.00,"discounted_cash":547.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":54.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":54.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":54.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":246.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":290.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":180.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":492.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":437.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":749.39,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":437.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":464.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":437.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":355.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":355.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":355.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":158.08,"methodology":"percent of total billed charges"}]}]},{"description":"CLIP SPN SNTRNI 17X12X6 ","code_information":[{"code":"357157","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6772.00,"discounted_cash":6772.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":677.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":677.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":677.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3047.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3597.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2230.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5417.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9277.64,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5417.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5756.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5417.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4401.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4401.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4401.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1957.11,"methodology":"percent of total billed charges"}]}]},{"description":"CLMP THERMOABLTN 60CM1 ","code_information":[{"code":"182473","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":66610.00,"discounted_cash":66610.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12655.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6661.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6661.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6661.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":12655.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":29974.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":35383.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":21941.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":26390.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":16386.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":16386.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":29308.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":59949.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":14854.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53288.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":91255.70,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":9991.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":9991.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56618.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":45294.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53288.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":19983.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43296.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43296.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43296.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":19250.29,"methodology":"percent of total billed charges"}]}]},{"description":"CLONAZEPAM 0.5MG TAB ","code_information":[{"code":"120809","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13.00,"discounted_cash":13.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4.28,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.20,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":17.81,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":8.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3.76,"methodology":"percent of total billed charges"}]}]},{"description":"CLONIDINE HCL 1 MG INJ ","drug_information":{"unit":"1","type":"ME"},"code_information":[{"code":"126342","type":"CDM"},{"code":"J0735","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":765.50,"discounted_cash":765.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":344.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":336.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":688.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":612.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":114.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":612.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":650.67,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":612.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":221.23,"methodology":"percent of total billed charges"}]}]},{"description":"CLOZAPINE 25 MG PO ","drug_information":{"unit":"25","type":"ME"},"code_information":[{"code":"120910","type":"CDM"},{"code":"S0136","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":32.75,"discounted_cash":32.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.27,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":14.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":29.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":44.87,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.91,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9.46,"methodology":"percent of total billed charges"}]}]},{"description":"CMPD DEXTROSE 50% 50S ","code_information":[{"code":"128244","type":"CDM"},{"code":"J7999","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":154.75,"discounted_cash":154.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":69.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":68.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":139.28,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":123.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":23.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":123.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":131.54,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":123.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":44.72,"methodology":"percent of total billed charges"}]}]},{"description":"CMPD HYMOR 50MG 50B ","code_information":[{"code":"128460","type":"CDM"},{"code":"J7999","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":122.25,"discounted_cash":122.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":55.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":53.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":110.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":97.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":18.34,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":97.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":103.91,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":97.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":35.33,"methodology":"percent of total billed charges"}]}]},{"description":"CMPD MORPH 50MG 50S ","code_information":[{"code":"126806","type":"CDM"},{"code":"J7999","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":81.25,"discounted_cash":81.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":36.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":35.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":73.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":12.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":69.06,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":23.48,"methodology":"percent of total billed charges"}]}]},{"description":"CMPD ROPIVCN 0.2% 750Q ","code_information":[{"code":"127742","type":"CDM"},{"code":"J7999","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2152.25,"discounted_cash":2152.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":968.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":946.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1937.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1721.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":322.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1721.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1829.41,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1721.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":622.00,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT ACTB HIP 60MM ","code_information":[{"code":"408772","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":45784.00,"discounted_cash":45784.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20602.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24320.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15081.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41205.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":38916.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13231.58,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT BIP HIP 48MM ","code_information":[{"code":"24329","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM 4 LT MDL RL KN ","code_information":[{"code":"173983","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14937.00,"discounted_cash":14937.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6721.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7934.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4920.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12696.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4316.79,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM 6 LT CMNT PST ","code_information":[{"code":"355698","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22430.00,"discounted_cash":22430.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10093.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11914.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7388.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20187.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19065.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6482.27,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM CMNTLS LT SZ6 ","code_information":[{"code":"438603","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM HIP SZ15 ","code_information":[{"code":"174411","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN 4 LT ","code_information":[{"code":"916903","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":50709.00,"discounted_cash":50709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22819.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26936.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16703.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45638.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43102.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14654.90,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN LM/RL SZ6 ","code_information":[{"code":"918532","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16610.00,"discounted_cash":16610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7474.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8823.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5471.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14949.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14118.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4800.29,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN LT SZ4 ","code_information":[{"code":"22755","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":50120.00,"discounted_cash":50120.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22554.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26623.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16509.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45108.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40096.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40096.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42602.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40096.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14484.68,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN LT SZ6 ","code_information":[{"code":"353254","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN LT SZ8 ","code_information":[{"code":"390014","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN RM/LL SZ3 ","code_information":[{"code":"920296","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16610.00,"discounted_cash":16610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7474.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8823.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5471.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14949.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14118.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4800.29,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN RT NAR 4N ","code_information":[{"code":"360917","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN RT SZ4 ","code_information":[{"code":"917604","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":58923.00,"discounted_cash":58923.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":26515.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":31299.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":19409.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":53030.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47138.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47138.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":50084.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47138.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":17028.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN RT SZ7 ","code_information":[{"code":"352965","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN ST SZ8 ","code_information":[{"code":"387787","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19399.00,"discounted_cash":19399.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8729.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10304.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6390.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17459.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16489.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5606.31,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN SZ2 ","code_information":[{"code":"409732","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN SZ5 ","code_information":[{"code":"357029","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19399.00,"discounted_cash":19399.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8729.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10304.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6390.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17459.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16489.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5606.31,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN SZ7 ","code_information":[{"code":"356729","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM KN SZC ","code_information":[{"code":"917965","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":115736.00,"discounted_cash":115736.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":52081.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":61478.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":38123.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":104162.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":92588.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":92588.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":98375.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":92588.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":33447.70,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM NAR KN LT SZ4 ","code_information":[{"code":"391217","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM NAR KN RT SZ4 ","code_information":[{"code":"390613","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM POR 2 ADV 2L ","code_information":[{"code":"174485","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM STD KN LT SZ9 ","code_information":[{"code":"390319","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM SZ2 PRIM LT ","code_information":[{"code":"413060","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21824.00,"discounted_cash":21824.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11592.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7188.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19641.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18550.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6307.14,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT FEM SZ4N RT ","code_information":[{"code":"172085","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30274.00,"discounted_cash":30274.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13623.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16081.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9972.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27246.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25732.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8749.19,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT GLND 46 ARTC TRB M ","code_information":[{"code":"173274","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13943.00,"discounted_cash":13943.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6274.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7406.52,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4592.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12548.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11154.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11154.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11851.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11154.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4029.53,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT GLND SHLDR 36MM ","code_information":[{"code":"387261","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27886.00,"discounted_cash":27886.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12548.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14813.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9185.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25097.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22308.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22308.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23703.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22308.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8059.05,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT HIP FEM SZ7 ","code_information":[{"code":"390700","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20611.00,"discounted_cash":20611.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9274.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10948.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6789.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18549.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17519.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5956.58,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN CMNTLS LT SZ1 ","code_information":[{"code":"425178","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN FEM LM/RL SZ5 ","code_information":[{"code":"408285","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16610.00,"discounted_cash":16610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7474.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8823.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5471.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14949.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14118.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13288.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4800.29,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN FEM LT SZ7 ","code_information":[{"code":"390863","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN FEM RT 90MM ","code_information":[{"code":"353280","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4693.00,"discounted_cash":4693.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2111.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2492.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1545.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4223.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3754.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3754.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3989.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3754.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1356.28,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN PLTR 38MM ","code_information":[{"code":"384600","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT KN SZ4 ","code_information":[{"code":"389585","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT NTKN2 SZ1-2 H13 ","code_information":[{"code":"175211","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16422.00,"discounted_cash":16422.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7389.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8723.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5409.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14779.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13137.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13137.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13958.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13137.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4745.96,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT PTLA 3PG STD28X6.2 ","code_information":[{"code":"353278","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6020.00,"discounted_cash":6020.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2709.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3197.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1982.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5418.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5117.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1739.78,"methodology":"percent of total billed charges"}]}]},{"description":"CMPNT PTLA KN 38MM ","code_information":[{"code":"173992","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMP FEM KN LT SZ7 ","code_information":[{"code":"352781","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMP FEM NO CLLR SZ7.5 ","code_information":[{"code":"426599","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20611.00,"discounted_cash":20611.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9274.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10948.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6789.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18549.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17519.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5956.58,"methodology":"percent of total billed charges"}]}]},{"description":"COMP GLND SHLDR SM 35MM ","code_information":[{"code":"385963","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16974.00,"discounted_cash":16974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9016.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5591.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15276.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14427.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4905.49,"methodology":"percent of total billed charges"}]}]},{"description":"COMP PAT FEM SZ3 LT ","code_information":[{"code":"172395","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23400.00,"discounted_cash":23400.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10530.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12430.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7707.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21060.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19890.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6762.60,"methodology":"percent of total billed charges"}]}]},{"description":"COMP SEG PT 70MM ","code_information":[{"code":"915173","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":35742.00,"discounted_cash":35742.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16083.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18986.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11773.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32167.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28593.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28593.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":30380.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28593.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10329.44,"methodology":"percent of total billed charges"}]}]},{"description":"COMPLEMENT C1 Q ","code_information":[{"code":"370390","type":"CDM"},{"code":"86160","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":9.57,"discounted_cash":9.57,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.82,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.82,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8.61,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.66,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.13,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6.51,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.66,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.77,"methodology":"percent of total billed charges"}]}]},{"description":"COMPLICATED PEPTIC ULCER WITHOUT CC/MCC ","code_information":[{"code":"382","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":14632.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":9480.46,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":11842.60,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":7739.15,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":9867.41,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":14485.68,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":6771.75,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":14632.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":13640.25,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":9480.46,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":10157.63,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":9673.93,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":14632.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":14632.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":9673.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":6771.75,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":6771.75,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":6771.75,"methodology":"fee schedule"}]}]},{"description":"COMPNT AGMNT LT 2.5X4MM ","code_information":[{"code":"350450","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10419.00,"discounted_cash":10419.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4688.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5534.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3432.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9377.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8335.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8335.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8856.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8335.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3011.09,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT CARPAL BALL SMALL ","code_information":[{"code":"356351","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10942.00,"discounted_cash":10942.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4923.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5812.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3604.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9847.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8753.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8753.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9300.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8753.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3162.24,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT DOME ANK SZ2 ","code_information":[{"code":"388594","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":92276.00,"discounted_cash":92276.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":41524.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":49017.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":30395.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":83048.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":73820.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":73820.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":78434.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":73820.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":26667.76,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM 00584201301 ","code_information":[{"code":"350499","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24612.00,"discounted_cash":24612.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11075.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13073.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8107.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22150.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20920.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19689.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7112.87,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM 4 RT KN CM ","code_information":[{"code":"173977","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM 6 NAR RT KN ","code_information":[{"code":"356740","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21824.00,"discounted_cash":21824.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11592.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7188.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19641.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18550.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6307.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM CRCTE RT KN 4 ","code_information":[{"code":"25755","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30274.00,"discounted_cash":30274.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13623.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16081.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9972.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27246.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25732.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24219.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8749.19,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM KN 6 RT ","code_information":[{"code":"410396","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":50709.00,"discounted_cash":50709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22819.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26936.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16703.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45638.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43102.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40567.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14654.90,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM KN LT SZ6 ","code_information":[{"code":"916821","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM KN RT SZ3 ","code_information":[{"code":"358909","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM KN SZ3 ","code_information":[{"code":"919594","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM KN2 SZ5 LT ","code_information":[{"code":"354734","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25461.00,"discounted_cash":25461.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11457.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13524.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8386.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22914.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21641.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7358.23,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM NAR LT SZ9 ","code_information":[{"code":"391367","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM PAT CMTD SZ2 ","code_information":[{"code":"173120","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23400.00,"discounted_cash":23400.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10530.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12430.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7707.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21060.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19890.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18720.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6762.60,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM RT KN SZ 8 ","code_information":[{"code":"355295","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22430.00,"discounted_cash":22430.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10093.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11914.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7388.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20187.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19065.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17944.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6482.27,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEM SM RT KN JRNY ","code_information":[{"code":"356175","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21314.00,"discounted_cash":21314.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9591.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11322.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7020.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19182.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17051.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17051.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18116.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17051.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6159.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT FEMRAL 5512-F-501 ","code_information":[{"code":"916878","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":50433.00,"discounted_cash":50433.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22694.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26790.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16612.63,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45389.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42868.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40346.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14575.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT GLND SHLDR 36MM ","code_information":[{"code":"174012","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12124.00,"discounted_cash":12124.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5455.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6440.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3993.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10305.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3503.84,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT INSERT ADAPTV CS ","code_information":[{"code":"359066","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT KN RT NPOR SZ2 ","code_information":[{"code":"355405","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20611.00,"discounted_cash":20611.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9274.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10948.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6789.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18549.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17519.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5956.58,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PSN ASF UC 13MM R ","code_information":[{"code":"358034","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12731.00,"discounted_cash":12731.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5728.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6762.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4193.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11457.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10821.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3679.26,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PSN VE R3-7CD 10 ","code_information":[{"code":"356937","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12731.00,"discounted_cash":12731.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5728.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6762.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4193.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11457.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10821.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3679.26,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PTLA KN 26MM ","code_information":[{"code":"916845","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PTLR 9X29MM ","code_information":[{"code":"391370","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5719.00,"discounted_cash":5719.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2573.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3037.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1883.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5147.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4575.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4575.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4861.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4575.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1652.79,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PTLR KN 3 8X29MM ","code_information":[{"code":"352934","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PTLR KN2 SZ2 10MM ","code_information":[{"code":"352031","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT PTLR TRI X3 8X29 ","code_information":[{"code":"175171","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6453.00,"discounted_cash":6453.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2903.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3427.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2125.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5807.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5162.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5162.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5485.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5162.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1864.92,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT SPCTRN FEM SZ 2 ","code_information":[{"code":"354410","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19399.00,"discounted_cash":19399.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8729.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10304.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6390.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17459.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16489.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15519.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5606.31,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT TIB BF LT MP 5 ","code_information":[{"code":"382604","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14549.00,"discounted_cash":14549.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6547.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7728.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4792.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13094.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12366.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4204.66,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT TIB KN RT GCK2 11 ","code_information":[{"code":"350141","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11506.00,"discounted_cash":11506.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5177.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6111.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3790.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10355.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9780.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3325.23,"methodology":"percent of total billed charges"}]}]},{"description":"COMPNT TIBTRY FNNED 67MM ","code_information":[{"code":"353282","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10106.00,"discounted_cash":10106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4547.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5368.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3328.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9095.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8084.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8084.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8590.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8084.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2920.63,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT DKY212 ","code_information":[{"code":"381193","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18361.00,"discounted_cash":18361.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8262.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9753.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6048.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16524.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14688.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14688.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15606.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14688.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5306.33,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM 3 RT CNSTR ","code_information":[{"code":"22943","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":49539.00,"discounted_cash":49539.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22292.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26315.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16318.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":44585.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39631.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39631.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":42108.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39631.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14316.77,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM 7 KN ","code_information":[{"code":"385617","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM KN LT 3 ","code_information":[{"code":"917923","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20248.00,"discounted_cash":20248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9111.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10755.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6669.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17210.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5851.67,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM KN RT SZ5 ","code_information":[{"code":"380921","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM KN SZF ","code_information":[{"code":"390609","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":98132.00,"discounted_cash":98132.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":44159.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":52127.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":32324.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":88318.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":78505.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":78505.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":83412.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":78505.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":28360.15,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT FEM XS LT KN ","code_information":[{"code":"913612","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19085.00,"discounted_cash":19085.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8588.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10137.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6286.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17176.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15268.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15268.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16222.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15268.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5515.56,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT HIP FEM SZ4 ","code_information":[{"code":"391395","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20611.00,"discounted_cash":20611.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9274.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10948.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6789.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18549.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17519.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5956.58,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT KN 8MM 35MM ","code_information":[{"code":"23430","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONENT TIB 8MM 3 RT M ","code_information":[{"code":"175081","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11506.00,"discounted_cash":11506.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5177.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6111.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3790.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10355.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9780.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9204.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3325.23,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONET FEM LT SZ2 ","code_information":[{"code":"744141","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23036.00,"discounted_cash":23036.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12236.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7588.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20732.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19580.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6657.40,"methodology":"percent of total billed charges"}]}]},{"description":"COMPONET FEM RT SZ5 ","code_information":[{"code":"744252","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23036.00,"discounted_cash":23036.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12236.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7588.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20732.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19580.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6657.40,"methodology":"percent of total billed charges"}]}]},{"description":"CONCTR ROD SPN 6.35X6.35 ","code_information":[{"code":"438973","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9481.00,"discounted_cash":9481.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4266.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5036.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3123.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8532.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7584.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7584.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8058.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7584.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2740.01,"methodology":"percent of total billed charges"}]}]},{"description":"CONE FEM HIP SZB 70MM ","code_information":[{"code":"408424","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":45784.00,"discounted_cash":45784.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20602.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24320.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15081.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41205.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":38916.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13231.58,"methodology":"percent of total billed charges"}]}]},{"description":"CONIVAPTAN 20 MG INJ ","drug_information":{"unit":"20","type":"ME"},"code_information":[{"code":"127628","type":"CDM"},{"code":"C9488","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6808.50,"discounted_cash":6808.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3063.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2995.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6127.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5446.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1021.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5446.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5787.23,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5446.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1967.66,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX IMGR2 5F038 PIG 65 ","code_information":[{"code":"468626","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":859.00,"discounted_cash":859.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":456.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":282.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":340.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":377.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1176.83,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":584.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":257.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.25,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX INFN 4FAR1 100 BX5 ","code_information":[{"code":"468376","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1358.00,"discounted_cash":1358.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":258.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":135.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":135.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":135.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":258.02,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":611.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":721.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":447.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":538.04,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":334.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":334.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":597.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1222.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":302.83,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1086.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1860.46,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":203.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":203.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1086.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1154.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":923.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1086.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":407.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":882.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":882.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":882.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":392.46,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX L65 VARREL ","code_information":[{"code":"182291","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":859.00,"discounted_cash":859.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":456.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":282.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":340.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":377.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1176.83,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":584.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":257.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.25,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX ST+ 6F ARMOD 100 ","code_information":[{"code":"468398","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.00,"discounted_cash":682.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.58,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":306.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":362.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":224.65,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":270.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":167.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":167.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":300.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":613.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":152.09,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":934.34,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.30,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":579.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":463.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":204.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":197.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX ST+ 6F LCB 100 ","code_information":[{"code":"468421","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":682.00,"discounted_cash":682.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.58,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":306.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":362.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":224.65,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":270.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":167.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":167.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":300.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":613.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":152.09,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":934.34,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.30,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":579.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":463.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":545.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":204.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":443.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":197.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHDX WSG 8F AR1 5PK ","code_information":[{"code":"381804","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":686.00,"discounted_cash":686.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":130.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":68.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":130.34,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":308.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":364.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":225.97,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":271.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":168.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":168.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":301.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":617.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":152.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":939.82,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":102.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":583.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":466.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":548.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":205.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":445.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":445.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":445.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":198.25,"methodology":"percent of total billed charges"}]}]},{"description":"CTHEP NVS 7F D4 TCP 174 ","code_information":[{"code":"467493","type":"CDM"},{"code":"C1732","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":40149.00,"discounted_cash":40149.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7628.31,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7628.31,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18067.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":21327.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":13225.08,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":15907.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9876.65,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9876.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":17665.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":36134.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8953.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32119.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6022.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32119.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34126.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":27301.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32119.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":12044.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11603.06,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD 6F MCH1 ART4SH ","code_information":[{"code":"381983","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3090.00,"discounted_cash":3090.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":587.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":587.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1390.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1641.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1017.85,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1224.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":760.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":760.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1359.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2781.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":689.07,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":463.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2626.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2101.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2472.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":927.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":893.01,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD ATTN 6216A-MB2 ","code_information":[{"code":"22574","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7610.00,"discounted_cash":7610.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1445.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3424.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4042.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2506.73,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3015.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1872.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3348.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6849.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1697.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1141.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6468.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5174.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6088.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2283.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2199.29,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD GLD JB2 5FR 100X40 ","code_information":[{"code":"359688","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2665.00,"discounted_cash":2665.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":506.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":506.35,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1199.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1415.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":877.85,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1055.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":655.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":655.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1172.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2398.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":594.29,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2132.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":399.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2132.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2265.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1812.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2132.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":799.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":770.18,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD LNCH 8F MB1 ","code_information":[{"code":"355907","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2408.00,"discounted_cash":2408.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":457.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":457.52,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1083.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1279.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":793.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":954.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":592.37,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":592.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1059.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":536.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":361.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2046.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1637.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1926.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":722.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":695.91,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 6F 070 AL1 ","code_information":[{"code":"468467","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 6F 070 JL6 100 ","code_information":[{"code":"182866","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 6X070AL.75 100 ","code_information":[{"code":"182871","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 6X070JL4.5 100 ","code_information":[{"code":"182864","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 7F 078 XB3 100 ","code_information":[{"code":"468465","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 8F 088 AL1 100 ","code_information":[{"code":"182918","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VBT 8X088AR1SH 100 ","code_information":[{"code":"382000","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2118.00,"discounted_cash":2118.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":402.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":953.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1125.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":697.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":839.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":521.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":931.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1906.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":472.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":317.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1800.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1440.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1694.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":635.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":612.10,"methodology":"percent of total billed charges"}]}]},{"description":"CTHGD VNTRE 1296-001 ","code_information":[{"code":"468629","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16799.00,"discounted_cash":16799.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3191.81,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3191.81,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7559.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8923.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5533.59,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6655.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4132.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4132.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7391.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15119.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3746.18,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13439.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2519.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13439.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14279.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":11423.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13439.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5039.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4854.91,"methodology":"percent of total billed charges"}]}]},{"description":"CUBE 2 HL PST RNCH EX FI ","code_information":[{"code":"380784","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7627.00,"discounted_cash":7627.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1449.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":762.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":762.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":762.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1449.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3432.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4051.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2512.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3021.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1876.24,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1876.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3355.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6864.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1700.82,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6101.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":10448.99,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1144.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1144.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6101.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6482.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5186.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6101.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2288.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4957.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4957.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4957.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2204.20,"methodology":"percent of total billed charges"}]}]},{"description":"CUFF URTH SPHNCR 4CM ","code_information":[{"code":"22083","type":"CDM"},{"code":"C1815","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36561.00,"discounted_cash":36561.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16452.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19421.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12043.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32904.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29248.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29248.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31076.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29248.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10566.13,"methodology":"percent of total billed charges"}]}]},{"description":"CULT CHLAMYDIA ","code_information":[{"code":"370450","type":"CDM"},{"code":"87110","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":116.25,"discounted_cash":116.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":22.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":22.09,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":52.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":51.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":104.63,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":25.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":93.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":17.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":93.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":98.81,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":79.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":93.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":33.60,"methodology":"percent of total billed charges"}]}]},{"description":"CULT FUNGUS OTHER SRC ","code_information":[{"code":"365140","type":"CDM"},{"code":"87102","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1183.50,"discounted_cash":1183.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":224.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":224.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":532.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":520.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1065.15,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":263.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":946.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":177.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":946.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1005.98,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":804.78,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":946.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":342.03,"methodology":"percent of total billed charges"}]}]},{"description":"CULT MYCOPLASMA ","code_information":[{"code":"367915","type":"CDM"},{"code":"87109","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":28.51,"discounted_cash":28.51,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25.66,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6.36,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.81,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.81,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24.23,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":19.39,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8.24,"methodology":"percent of total billed charges"}]}]},{"description":"CULT TYPING DIRECT PROBE ","code_information":[{"code":"373002","type":"CDM"},{"code":"87149","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":20.36,"discounted_cash":20.36,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":8.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18.32,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4.54,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16.29,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17.31,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16.29,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5.88,"methodology":"percent of total billed charges"}]}]},{"description":"CULTURE ANAEROBIC ","code_information":[{"code":"365080","type":"CDM"},{"code":"87075","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1634.25,"discounted_cash":1634.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":310.51,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":310.51,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":735.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":719.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1470.83,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":364.44,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1307.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":245.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1307.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1389.11,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1111.29,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1307.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":472.30,"methodology":"percent of total billed charges"}]}]},{"description":"CULTURE STOOL ","code_information":[{"code":"365190","type":"CDM"},{"code":"87045","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":940.50,"discounted_cash":940.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":178.69,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":178.69,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":423.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":413.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":846.45,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":209.73,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":752.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":141.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":752.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":799.42,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":639.54,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":752.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":271.80,"methodology":"percent of total billed charges"}]}]},{"description":"CUP 45MM BIPOLAR ","code_information":[{"code":"21977","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"CUP ACET 6X58X52 CONSERV ","code_information":[{"code":"26418","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"CUP ACTB 58 RVSN ","code_information":[{"code":"24447","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30154.00,"discounted_cash":30154.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13569.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16017.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9932.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27138.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24123.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24123.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25630.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24123.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8714.51,"methodology":"percent of total billed charges"}]}]},{"description":"CUP ACTB HIP 48OD 42ID ","code_information":[{"code":"26573","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21824.00,"discounted_cash":21824.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11592.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7188.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19641.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18550.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6307.14,"methodology":"percent of total billed charges"}]}]},{"description":"CUP ACTB PNCL 300 56 ","code_information":[{"code":"23922","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12852.00,"discounted_cash":12852.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5783.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6826.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4233.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11566.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10281.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10281.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10924.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10281.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3714.23,"methodology":"percent of total billed charges"}]}]},{"description":"CUP CERV LARGE 37MM ","code_information":[{"code":"380697","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2755.00,"discounted_cash":2755.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":523.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":523.45,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1239.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1463.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":907.50,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1091.53,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":677.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":677.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1212.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2479.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":614.37,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2204.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3774.35,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":413.25,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":413.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2204.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2341.75,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1873.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2204.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":826.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1790.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1790.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1790.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":796.20,"methodology":"percent of total billed charges"}]}]},{"description":"CUP HUM 38MM DLT XTND ","code_information":[{"code":"357931","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14549.00,"discounted_cash":14549.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6547.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7728.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4792.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13094.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12366.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4204.66,"methodology":"percent of total billed charges"}]}]},{"description":"CUP SHELL 3H SZ52C ","code_information":[{"code":"434274","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10912.00,"discounted_cash":10912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4910.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5796.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3594.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9275.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3153.57,"methodology":"percent of total billed charges"}]}]},{"description":"CURETTE CRVD 7MM ","code_information":[{"code":"913773","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":303.00,"discounted_cash":303.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":57.57,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":30.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":30.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":30.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":57.57,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":136.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":160.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":99.81,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":120.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":74.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":74.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":133.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":272.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":67.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":242.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":415.11,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":45.45,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":45.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":242.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":257.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":206.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":242.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":90.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":196.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":196.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":196.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":87.57,"methodology":"percent of total billed charges"}]}]},{"description":"CUTR ASCOPIC 5.5 RSCTR ","code_information":[{"code":"385657","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2063.00,"discounted_cash":2063.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":206.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":206.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":206.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":391.97,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":928.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1095.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":679.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":817.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":507.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":907.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1856.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":460.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2826.31,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":309.45,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":309.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1753.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1402.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1650.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":618.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1340.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1340.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1340.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":596.21,"methodology":"percent of total billed charges"}]}]},{"description":"CUTTER MICROMX 1MM M-1DC ","code_information":[{"code":"20839","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1429.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":752.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":752.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":752.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1429.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2981.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1851.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1851.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3311.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1678.08,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":10309.25,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1128.75,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1128.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5117.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2257.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4891.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4891.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4891.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"CVC NON-TUN CENT INS <5Y ","code_information":[{"code":"460004","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14144.75,"discounted_cash":14144.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1414.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1414.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1414.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6365.14,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5604.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3479.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3479.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6223.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12730.27,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3154.28,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11315.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":19378.31,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2121.71,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2121.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11315.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12023.04,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9194.09,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9194.09,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9194.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4087.83,"methodology":"percent of total billed charges"}]}]},{"description":"CYANIDE ","code_information":[{"code":"372600","type":"CDM"},{"code":"82600","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":37.00,"discounted_cash":37.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.03,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":16.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":25.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10.69,"methodology":"percent of total billed charges"}]}]},{"description":"CYCLOPENTOLATE 0.5% OP ","code_information":[{"code":"125079","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":417.50,"discounted_cash":417.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":79.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":41.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":41.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":41.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":79.33,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":187.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":221.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":137.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":102.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":102.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":183.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":375.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":93.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":334.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":571.98,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":62.63,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":62.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":334.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":354.88,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":283.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":334.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":125.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":271.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":271.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":271.38,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":120.66,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST INSPR SRF220CC ","code_information":[{"code":"387663","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13960.00,"discounted_cash":13960.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6282.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7415.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4598.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12564.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11866.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4034.44,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST INSPR SRM345CC ","code_information":[{"code":"382403","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13960.00,"discounted_cash":13960.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6282.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7415.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4598.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12564.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11866.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4034.44,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST INSPRA SRLP190 ","code_information":[{"code":"360106","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13960.00,"discounted_cash":13960.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6282.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7415.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4598.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12564.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11866.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11168.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4034.44,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST SMTH RND 325CC ","code_information":[{"code":"431997","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST STYL TCF 325CC ","code_information":[{"code":"360961","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14978.00,"discounted_cash":14978.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6740.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7956.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4933.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13480.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12731.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4328.64,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL BRST STYL TCM 310CC ","code_information":[{"code":"360973","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14978.00,"discounted_cash":14978.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6740.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7956.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4933.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13480.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12731.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11982.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4328.64,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL FX PHLNX FNG TOE SM ","code_information":[{"code":"383418","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23488.00,"discounted_cash":23488.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10569.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12476.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7736.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21139.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18790.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18790.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19964.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18790.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6788.03,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL SPN 7D 11X14X7MM ","code_information":[{"code":"920223","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":16694.00,"discounted_cash":16694.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1669.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1669.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1669.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7512.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8867.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5499.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":22870.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10851.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10851.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10851.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4824.57,"methodology":"percent of total billed charges"}]}]},{"description":"IMPL TOE SZ2S ","code_information":[{"code":"171005","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11579.00,"discounted_cash":11579.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5210.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6150.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3814.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10421.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9263.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9263.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9842.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9263.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3346.33,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT AXAILIF SPINAL S ","code_information":[{"code":"174057","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":149264.00,"discounted_cash":149264.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":67168.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":79289.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":49167.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":134337.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":119411.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":119411.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":126874.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":119411.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":43137.30,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 200CC ","code_information":[{"code":"357144","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12350.00,"discounted_cash":12350.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5557.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6560.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4068.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11115.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9880.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9880.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10497.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9880.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3569.15,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 340CC ","code_information":[{"code":"412415","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 420CC ","code_information":[{"code":"380181","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 465CC ","code_information":[{"code":"387636","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15142.00,"discounted_cash":15142.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6813.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8043.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4987.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13627.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12113.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12113.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12870.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12113.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4376.04,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 520CC ","code_information":[{"code":"360178","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17727.00,"discounted_cash":17727.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7977.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9416.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5839.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15954.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15067.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5123.10,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 560CC ","code_information":[{"code":"380304","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 650CC ","code_information":[{"code":"171418","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9912.00,"discounted_cash":9912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4460.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5265.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3265.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8920.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7929.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7929.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8425.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7929.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2864.57,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 700CC ","code_information":[{"code":"380134","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16176.00,"discounted_cash":16176.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7279.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8592.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5328.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14558.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13749.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4674.86,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST 790CC ","code_information":[{"code":"386129","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16988.00,"discounted_cash":16988.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7644.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9024.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5595.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15289.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14439.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4909.53,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BREAST SCM-445 ","code_information":[{"code":"382247","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16176.00,"discounted_cash":16176.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7279.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8592.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5328.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14558.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13749.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12940.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4674.86,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 11.5X10.3CM ","code_information":[{"code":"358184","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15880.00,"discounted_cash":15880.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7146.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8435.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5230.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14292.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13498.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4589.32,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 125ML PRFL ","code_information":[{"code":"174389","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 14X12.9CM S ","code_information":[{"code":"359749","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 190ML GEL ","code_information":[{"code":"359664","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 245ML CPG12 ","code_information":[{"code":"355581","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15880.00,"discounted_cash":15880.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7146.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8435.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5230.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14292.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13498.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4589.32,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 275CC SIL ","code_information":[{"code":"171992","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 325-50ML ","code_information":[{"code":"354543","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 350ML GEL S ","code_information":[{"code":"356624","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 400ML SMTH ","code_information":[{"code":"356626","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 425+85ML ST ","code_information":[{"code":"355463","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 450ML RND ","code_information":[{"code":"24995","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10695.00,"discounted_cash":10695.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4812.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5681.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3522.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9625.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8556.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8556.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9090.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8556.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3090.86,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 500MLHIPRFL ","code_information":[{"code":"23277","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 560CC SMTH ","code_information":[{"code":"360892","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11744.00,"discounted_cash":11744.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5284.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6238.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3868.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10569.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9395.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9395.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9982.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9395.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3394.02,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 650ML PRFL ","code_information":[{"code":"360152","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13295.00,"discounted_cash":13295.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5982.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7062.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4379.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11965.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11300.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10636.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3842.26,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST 740CC ","code_information":[{"code":"429675","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19204.00,"discounted_cash":19204.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8641.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10201.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6325.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17283.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16323.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5549.96,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST GEL 300ML ","code_information":[{"code":"356411","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST GEL 450ML ","code_information":[{"code":"23439","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST GEL 700CC ","code_information":[{"code":"356546","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST MMRYSHP 650 ","code_information":[{"code":"356562","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15880.00,"discounted_cash":15880.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7146.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8435.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5230.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14292.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13498.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4589.32,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST SMTH 455ML ","code_information":[{"code":"380592","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT BRST150MLHI PRFL ","code_information":[{"code":"360830","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT DUR KNE PATELLA ","code_information":[{"code":"744093","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5042.00,"discounted_cash":5042.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2268.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2678.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1660.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4537.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4285.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4033.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1457.14,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT FX MEDIUM ","code_information":[{"code":"381429","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18708.00,"discounted_cash":18708.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8418.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9937.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6162.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16837.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15901.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14966.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5406.61,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT ORTH 40MM 7MM ","code_information":[{"code":"352471","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":62200.00,"discounted_cash":62200.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":27990.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":33040.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":20488.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":55980.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49760.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49760.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":52870.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49760.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":17975.80,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT SACR 10.5X70MM ","code_information":[{"code":"917096","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":46532.00,"discounted_cash":46532.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20939.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24717.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15327.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41878.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":39552.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37225.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13447.75,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT SPN PLVC 7X45MM ","code_information":[{"code":"381215","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":60393.00,"discounted_cash":60393.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":27176.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":32080.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":19893.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":54353.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":48314.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":48314.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":51334.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":48314.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":17453.58,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT SPN PLVC 7X80MM ","code_information":[{"code":"387081","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":38397.00,"discounted_cash":38397.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17278.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20396.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12647.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":34557.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32637.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30717.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11096.73,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLANT TOE HINGED FLEX ","code_information":[{"code":"172166","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8684.00,"discounted_cash":8684.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3907.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4612.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2860.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7815.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6947.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6947.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7381.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6947.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2509.68,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT 405BRST NTRLLE ","code_information":[{"code":"390064","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17727.00,"discounted_cash":17727.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7977.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9416.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5839.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15954.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15067.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14181.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5123.10,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT BRST 185ML SMTH ","code_information":[{"code":"359210","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT BRST 430ML SMTH ","code_information":[{"code":"356627","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10326.00,"discounted_cash":10326.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4646.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5485.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3401.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9293.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8777.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8260.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2984.21,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT BRST INSPIR 360CC ","code_information":[{"code":"380619","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12557.00,"discounted_cash":12557.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5650.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6670.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4136.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11301.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10673.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10045.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3628.97,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT ELB SYS TOG/ZLOOP ","code_information":[{"code":"426311","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15068.00,"discounted_cash":15068.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6780.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8004.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4963.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13561.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12054.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12054.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12807.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12054.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4354.65,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLNT SPN 60X22X12MM 8D ","code_information":[{"code":"353791","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":78560.00,"discounted_cash":78560.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":41731.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":25877.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":107627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66776.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22703.84,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLT BRST 12.5X10.5CM ","code_information":[{"code":"359948","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17782.00,"discounted_cash":17782.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8001.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9445.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5857.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16003.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15114.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5139.00,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLT BRST SIL 365GM ","code_information":[{"code":"359949","type":"CDM"},{"code":"C1789","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17782.00,"discounted_cash":17782.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8001.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9445.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5857.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16003.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15114.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14225.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5139.00,"methodology":"percent of total billed charges"}]}]},{"description":"INCUBATED AUTO SCREEN ","code_information":[{"code":"372725","type":"CDM"},{"code":"86941","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":61.25,"discounted_cash":61.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":11.64,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":11.64,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":27.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":26.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":55.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":13.66,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":9.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":52.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":41.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":49.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":17.70,"methodology":"percent of total billed charges"}]}]},{"description":"INDOCYANINE-GN 25 MG INJ ","drug_information":{"unit":"25","type":"ME"},"code_information":[{"code":"127868","type":"CDM"},{"code":"Q9968","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1037.50,"discounted_cash":1037.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":466.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":456.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":933.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":830.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":155.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":830.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":881.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":830.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":299.84,"methodology":"percent of total billed charges"}]}]},{"description":"INF AGENT CONCENTRATION ","code_information":[{"code":"365000","type":"CDM"},{"code":"87015","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":77.50,"discounted_cash":77.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":14.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":14.72,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":34.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":69.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":17.28,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":11.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":65.88,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":52.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"}]}]},{"description":"INFECT AGENT AG NOS OIA ","code_information":[{"code":"372719","type":"CDM"},{"code":"87899","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":11.25,"discounted_cash":11.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.14,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.14,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.51,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9.56,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3.25,"methodology":"percent of total billed charges"}]}]},{"description":"INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC ","code_information":[{"code":"728","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":15463.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":10259.66,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":12641.03,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":8375.23,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":10678.42,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":15308.37,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":7328.33,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":15463.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":14761.35,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":10259.66,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":10992.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":10469.04,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":15463.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":15463.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":10469.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":7328.33,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":7328.33,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":7328.33,"methodology":"fee schedule"}]}]},{"description":"INFLUENZA A AG EIA ","code_information":[{"code":"20809","type":"CDM"},{"code":"87400","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":261.25,"discounted_cash":261.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":49.64,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":49.64,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":117.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":114.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":235.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":58.26,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":209.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":39.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":209.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":222.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":177.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":209.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":75.50,"methodology":"percent of total billed charges"}]}]},{"description":"INH ALBUTEROL CONC 2.5MG ","code_information":[{"code":"126201","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8.75,"discounted_cash":8.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11.99,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7.44,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.53,"methodology":"percent of total billed charges"}]}]},{"description":"INH NACL 3% 4 ML ","code_information":[{"code":"128203","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4.00,"discounted_cash":4.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.76,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1.32,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":0.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5.48,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.16,"methodology":"percent of total billed charges"}]}]},{"description":"INJ CATH ABS/CYST ","code_information":[{"code":"279424","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3053.25,"discounted_cash":3053.25,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1373.96,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1209.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":751.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":751.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1343.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2747.93,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":680.87,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2442.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4182.95,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":457.99,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":457.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2442.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2595.26,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":882.39,"methodology":"percent of total billed charges"}]}]},{"description":"INJ CHOLANGIO NEW ACCES ","code_information":[{"code":"287532","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15616.00,"discounted_cash":15616.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1561.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1561.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1561.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7027.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6187.06,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3841.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3841.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6871.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14054.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3482.37,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12492.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21393.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2342.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2342.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12492.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13273.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10150.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10150.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10150.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4513.02,"methodology":"percent of total billed charges"}]}]},{"description":"INJ EPI C/T WO IMAGING ","code_information":[{"code":"272320","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4538.00,"discounted_cash":4538.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":453.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":453.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":453.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2042.10,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1797.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1116.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1116.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1996.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4084.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1011.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3630.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":6217.06,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":680.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":680.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3630.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3857.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2949.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2949.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2949.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1311.48,"methodology":"percent of total billed charges"}]}]},{"description":"INJ MYELOGRAM SPINE ","code_information":[{"code":"282284","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6893.75,"discounted_cash":6893.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":689.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":689.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":689.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3102.19,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2731.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1695.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1695.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3033.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6204.38,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1537.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5515.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9444.44,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1034.06,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1034.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5515.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5859.69,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4480.94,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4480.94,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4480.94,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1992.29,"methodology":"percent of total billed charges"}]}]},{"description":"INJ PERITONEAL CAVITY ","code_information":[{"code":"279400","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3053.25,"discounted_cash":3053.25,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":305.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1373.96,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1209.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":751.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":751.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1343.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2747.93,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":680.87,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2442.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4182.95,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":457.99,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":457.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2442.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2595.26,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1984.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":882.39,"methodology":"percent of total billed charges"}]}]},{"description":"INJ SI ANES/STD/TH AG ","code_information":[{"code":"277096","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2999.50,"discounted_cash":2999.50,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":299.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":299.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":299.95,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1349.78,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1188.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":737.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":737.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1319.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2699.55,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":668.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2399.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4109.31,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":449.93,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":449.93,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2399.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2549.57,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1949.67,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1949.67,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1949.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":866.86,"methodology":"percent of total billed charges"}]}]},{"description":"INJ VENOGRAM ","code_information":[{"code":"463005","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3327.50,"discounted_cash":3327.50,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":332.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1497.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1318.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":818.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":818.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1464.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2994.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":742.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2662.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4558.68,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":499.13,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":499.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2662.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2828.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2162.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":961.65,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"624009","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"700116","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"700196","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"713072","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"717072","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INJECTION IM OR SQ ","code_information":[{"code":"731072","type":"CDM"},{"code":"96372","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"INLAY INTBRTB SPN 12MM ","code_information":[{"code":"385104","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1354.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1354.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1354.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":18555.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8803.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8803.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":8803.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"INS ARTC KN 15MM SZ3-4 ","code_information":[{"code":"388191","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7881.00,"discounted_cash":7881.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3546.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4186.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2596.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7092.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6698.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2277.61,"methodology":"percent of total billed charges"}]}]},{"description":"INS CVC NON-TUN CENT=>5Y ","code_information":[{"code":"463556","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7237.00,"discounted_cash":7237.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":723.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":723.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":723.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3256.65,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2867.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1780.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1780.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3184.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6513.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1613.85,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5789.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9914.69,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1085.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1085.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5789.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6151.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4704.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4704.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4704.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2091.49,"methodology":"percent of total billed charges"}]}]},{"description":"INS ICD GEN ONLY SGL LD ","code_information":[{"code":"461062","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":103596.00,"discounted_cash":103596.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10359.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10359.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10359.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":46618.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":41044.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":25484.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":25484.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":45582.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":93236.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":23101.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82876.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":141926.52,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":15539.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":15539.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82876.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":88056.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67337.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67337.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67337.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":29939.24,"methodology":"percent of total billed charges"}]}]},{"description":"INS PACEMAKER VENT ","code_information":[{"code":"461020","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":33279.25,"discounted_cash":33279.25,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3327.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3327.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3327.93,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14975.66,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":13185.24,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8186.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8186.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":14642.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":29951.33,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7421.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26623.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":45592.57,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4991.89,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4991.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26623.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28287.36,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21631.51,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21631.51,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":21631.51,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9617.70,"methodology":"percent of total billed charges"}]}]},{"description":"INS PPM GEN ONLY SGL LD ","code_information":[{"code":"461005","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":30427.00,"discounted_cash":30427.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3042.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3042.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3042.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13692.15,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12055.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7485.04,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7485.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13387.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27384.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6785.22,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24341.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":41684.99,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4564.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4564.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24341.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25862.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19777.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19777.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19777.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8793.40,"methodology":"percent of total billed charges"}]}]},{"description":"INS TIB 2X8 STAB XLNK ","code_information":[{"code":"174230","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"INS TIB 5 H10 CRV XLNK ","code_information":[{"code":"25691","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"INS TIB FX KN LT SZC ","code_information":[{"code":"387192","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27825.00,"discounted_cash":27825.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12521.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14780.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9165.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25042.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23651.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22260.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8041.43,"methodology":"percent of total billed charges"}]}]},{"description":"INS TIB SZ6 RT SCRLES BF ","code_information":[{"code":"382760","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14549.00,"discounted_cash":14549.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6547.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7728.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4792.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13094.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12366.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4204.66,"methodology":"percent of total billed charges"}]}]},{"description":"INS TIB THK RT MED 10 ","code_information":[{"code":"26464","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"INS VAGINAL BRACHYTX DEV ","code_information":[{"code":"107738","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1543.25,"discounted_cash":1543.25,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":154.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":154.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":154.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":694.46,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":611.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":379.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":679.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1388.92,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":344.14,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1234.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2114.25,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":231.49,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":231.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1234.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1311.76,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1003.11,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1003.11,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1003.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":446.00,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ACETB APR HOODED ","code_information":[{"code":"24526","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7748.00,"discounted_cash":7748.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3486.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4115.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2552.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6973.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6585.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2239.17,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ACTB 54-56X32X10 ","code_information":[{"code":"173689","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10651.00,"discounted_cash":10651.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4792.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5657.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3508.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9585.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9053.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8520.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3078.14,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ACTB HIP 4.9X32MM ","code_information":[{"code":"390673","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ADPTV EVOL MP CS ","code_information":[{"code":"358538","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ART KN 3-4-5 11MM ","code_information":[{"code":"350430","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10912.00,"discounted_cash":10912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4910.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5796.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3594.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9275.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3153.57,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ART KN 3-4-5 16MM ","code_information":[{"code":"355991","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ARTC 10-11 12MM ","code_information":[{"code":"438875","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ARTC 3 RT MDL L/L ","code_information":[{"code":"174035","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14937.00,"discounted_cash":14937.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6721.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7934.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4920.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12696.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11949.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4316.79,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ARTC 5-6 E-F 14MM ","code_information":[{"code":"350862","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10912.00,"discounted_cash":10912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4910.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5796.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3594.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9275.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3153.57,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ARTC 7-8 9MM KN ","code_information":[{"code":"353372","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8487.00,"discounted_cash":8487.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3819.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4508.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2795.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6789.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6789.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7213.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6789.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2452.74,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ1 9MM ","code_information":[{"code":"915503","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ2 9MM ","code_information":[{"code":"391338","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ3 10MM ","code_information":[{"code":"915517","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ3 14MM ","code_information":[{"code":"426288","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ3-4 11MM ","code_information":[{"code":"385700","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7881.00,"discounted_cash":7881.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3546.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4186.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2596.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7092.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6698.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2277.61,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ4 10MM ","code_information":[{"code":"380568","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ4 13MM ","code_information":[{"code":"431415","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ4 8MM ","code_information":[{"code":"24308","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ5 ","code_information":[{"code":"425590","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14549.00,"discounted_cash":14549.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6547.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7728.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4792.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13094.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12366.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11639.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4204.66,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ5 14MM ","code_information":[{"code":"408683","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ5-6 15MM ","code_information":[{"code":"386172","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7881.00,"discounted_cash":7881.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3546.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4186.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2596.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7092.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6698.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2277.61,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ6 12MM ","code_information":[{"code":"391232","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22745.00,"discounted_cash":22745.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10235.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12082.14,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7492.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20470.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18196.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18196.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19333.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18196.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6573.31,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ6-9 16MM ","code_information":[{"code":"424905","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ7 9MM ","code_information":[{"code":"410322","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN SZ7-8 9MM ","code_information":[{"code":"359954","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7881.00,"discounted_cash":7881.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3546.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4186.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2596.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7092.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6698.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2277.61,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB KN UHMWP 25MM ","code_information":[{"code":"350775","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25778.00,"discounted_cash":25778.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11600.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13693.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8491.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23200.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20622.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20622.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21911.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20622.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7449.84,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB LT KN 0 13MM ","code_information":[{"code":"13107","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10912.00,"discounted_cash":10912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4910.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5796.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3594.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9275.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8729.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3153.57,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB PFC 2.5 X10MM ","code_information":[{"code":"174005","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13531.00,"discounted_cash":13531.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6088.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7187.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4457.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12177.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11501.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3910.46,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB RT ADV2 SZ 2 ","code_information":[{"code":"173262","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB SM 4MM ","code_information":[{"code":"389727","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":692.00,"discounted_cash":692.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":311.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":367.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":227.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":622.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":553.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":553.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":588.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":553.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":199.99,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB SZ2.5 17.5MM ","code_information":[{"code":"172355","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13531.00,"discounted_cash":13531.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6088.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7187.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4457.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12177.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11501.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10824.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3910.46,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB SZ5 8MM KN ","code_information":[{"code":"172274","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIB XS UNV 12MM ","code_information":[{"code":"174663","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":35136.00,"discounted_cash":35136.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":15811.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18664.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11573.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":31622.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28108.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28108.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":29865.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28108.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10154.30,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIBIA PROX 10MM ","code_information":[{"code":"408281","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9166.00,"discounted_cash":9166.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4124.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4868.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3019.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8249.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7332.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7332.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7791.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7332.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2648.97,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIBIAL 10MM SZ3 ","code_information":[{"code":"173314","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT TIBIAL SIZE 3/4/5 ","code_information":[{"code":"13125","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT XLPE 22/40MM ","code_information":[{"code":"389131","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14436.00,"discounted_cash":14436.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6496.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7668.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4755.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12992.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12270.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4172.00,"methodology":"percent of total billed charges"}]}]},{"description":"INSERTER TIP SPN MED 5MM ","code_information":[{"code":"184581","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5581.00,"discounted_cash":5581.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1060.39,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":558.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":558.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":558.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1060.39,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2511.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2964.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1838.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2211.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1372.93,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1372.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2455.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5022.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1244.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4464.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":7645.97,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":837.15,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":837.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4464.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4743.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3795.08,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4464.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1674.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3627.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3627.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3627.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1612.91,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT ACTB 28X48 HAYS HP ","code_information":[{"code":"24798","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT ARTC KN 10-11 12MM ","code_information":[{"code":"438865","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT ARTC KN 10-12 20MM ","code_information":[{"code":"438880","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT ARTC KN RT 11MM ","code_information":[{"code":"388177","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT ATTN PS FB SZ7 5MM ","code_information":[{"code":"355697","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT KN LT SZ3-4 12MM ","code_information":[{"code":"410492","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT TIB 5-6 15MM ","code_information":[{"code":"351621","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10306.00,"discounted_cash":10306.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4637.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5474.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3394.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9275.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8244.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8244.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8760.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8244.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2978.43,"methodology":"percent of total billed charges"}]}]},{"description":"INST BIOPSY 14G 15CM 1MM ","code_information":[{"code":"388695","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2287.00,"discounted_cash":2287.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":434.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":434.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1029.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1214.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":753.34,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":906.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":562.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":562.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1006.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2058.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":510.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1829.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3133.19,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":343.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":343.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1829.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1943.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1555.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1829.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":686.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1486.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1486.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1486.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":660.94,"methodology":"percent of total billed charges"}]}]},{"description":"INSTRMNT 1ST MET TRNSLTR ","code_information":[{"code":"390157","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5792.00,"discounted_cash":5792.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1100.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":579.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":579.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":579.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1100.48,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2606.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3076.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1907.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2294.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1424.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1424.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2548.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5212.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1291.62,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4633.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":7935.04,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":868.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":868.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4633.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4923.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3938.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4633.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1737.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1673.89,"methodology":"percent of total billed charges"}]}]},{"description":"INSULIN 20 U INJ ","drug_information":{"unit":"20","type":"UN"},"code_information":[{"code":"127785","type":"CDM"},{"code":"J1815","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":33.25,"discounted_cash":33.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":17.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":13.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":14.63,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":29.93,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28.26,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":22.61,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9.61,"methodology":"percent of total billed charges"}]}]},{"description":"INSULIN 5 U INJ ","drug_information":{"unit":"5","type":"UN"},"code_information":[{"code":"126700","type":"CDM"},{"code":"J1815","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6.25,"discounted_cash":6.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.19,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.19,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2.06,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5.63,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.39,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5.31,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.81,"methodology":"percent of total billed charges"}]}]},{"description":"INTBDY SPN 31X24X10MM ","code_information":[{"code":"412628","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":39280.00,"discounted_cash":39280.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20865.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12938.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":53813.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33388.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11351.92,"methodology":"percent of total billed charges"}]}]},{"description":"INTEGRA MATRIX 1SQCM ","drug_information":{"unit":"1","type":"EA"},"code_information":[{"code":"423032","type":"CDM"},{"code":"Q4108","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":442.00,"discounted_cash":442.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":198.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":194.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":397.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":66.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":375.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":127.74,"methodology":"percent of total billed charges"}]}]},{"description":"INTERBDY CERV 15X13X10MM ","code_information":[{"code":"358088","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15909.00,"discounted_cash":15909.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7159.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8450.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5240.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14318.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21795.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13522.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4597.70,"methodology":"percent of total billed charges"}]}]},{"description":"INTERBDY CERV17X13.5X7MM ","code_information":[{"code":"358093","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15909.00,"discounted_cash":15909.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7159.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8450.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5240.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14318.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21795.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13522.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4597.70,"methodology":"percent of total billed charges"}]}]},{"description":"INTERBODY SPN 17X13.5X6 ","code_information":[{"code":"437145","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"INTERF BETA1A 30MCG IM ","drug_information":{"unit":"30","type":"GM"},"code_information":[{"code":"126603","type":"CDM"},{"code":"Q3027","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8779.25,"discounted_cash":8779.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1668.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1668.06,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3950.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4663.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2891.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3478.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3862.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7901.32,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1957.77,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7023.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1316.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7023.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7462.36,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5969.89,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7023.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2633.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2537.20,"methodology":"percent of total billed charges"}]}]},{"description":"INTERMED LT TIBL INSERT ","code_information":[{"code":"744121","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INTERMED LT TIBL INSERT ","code_information":[{"code":"746825","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INTERMED RT TIBL INSER ","code_information":[{"code":"744207","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INTERMED RT TIBL INSERT ","code_information":[{"code":"746811","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"INTMD STM TIB SZ 5 ","code_information":[{"code":"744179","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11033.00,"discounted_cash":11033.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4964.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5860.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3634.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9929.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9378.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3188.54,"methodology":"percent of total billed charges"}]}]},{"description":"INTR LD SCOUTPRO TL SLTR ","code_information":[{"code":"387569","type":"CDM"},{"code":"C1892","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC ","code_information":[{"code":"064","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":38711.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":23729.10,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":30337.25,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":19370.70,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":24697.64,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":38323.89,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":16949.36,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":38711.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":34140.85,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":23729.10,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":25424.04,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":24213.37,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":38711.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":38711.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":24213.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":16949.36,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":16949.36,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":16949.36,"methodology":"fee schedule"}]}]},{"description":"INTRAPULM PERC SUBSQ ","code_information":[{"code":"540256","type":"CDM"},{"code":"94668","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":496.00,"discounted_cash":496.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":94.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":94.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":223.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":196.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":218.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":446.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":110.61,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":396.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":74.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":396.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":421.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":337.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":396.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":143.34,"methodology":"percent of total billed charges"}]}]},{"description":"IVIG PRIVIGEN 500 MGJW ","drug_information":{"unit":"500","type":"ME"},"code_information":[{"code":"127708","type":"CDM"},{"code":"J1459","type":"HCPCS"}],"standard_charges":[{"modifiers":"JW","modifiers_description":"Drug amount discarded/not administered to any patient","setting":"outpatient","gross_charge":315.00,"discounted_cash":315.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":141.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":138.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":283.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":252.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":47.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":252.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":267.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":252.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":91.03,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DR GY ","code_information":[{"code":"700102","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DR GY ","code_information":[{"code":"711095","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DR GY ","code_information":[{"code":"725095","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DRUG ","code_information":[{"code":"624011","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DRUG ","code_information":[{"code":"700199","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ NEW DRUG ","code_information":[{"code":"717075","type":"CDM"},{"code":"96375","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ S DRUG GY ","code_information":[{"code":"107723","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":337.50,"discounted_cash":337.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":64.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":64.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":151.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":179.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":111.17,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":133.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":83.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":83.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":148.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":303.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":75.26,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":270.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":50.63,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":270.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":286.88,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":229.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":270.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":101.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":97.54,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ S DRUG GY ","code_information":[{"code":"700141","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ S DRUG GY ","code_information":[{"code":"713096","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ S DRUG GY ","code_information":[{"code":"731096","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ SAME DRUG ","code_information":[{"code":"700076","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ SAME DRUG ","code_information":[{"code":"711076","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP EA ADD SEQ SAME DRUG ","code_information":[{"code":"725076","type":"CDM"},{"code":"96376","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SINGLE/INITIAL DRUG ","code_information":[{"code":"619023","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SINGLE/INITIAL DRUG ","code_information":[{"code":"700178","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SINGLE/INITIAL DRUG ","code_information":[{"code":"716074","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SINGLE/INITIAL DRUG ","code_information":[{"code":"809774","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":544.00,"discounted_cash":544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":244.80,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":215.53,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":133.82,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":133.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":239.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":489.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":435.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":435.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":462.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":369.92,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":157.22,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SNGL/INITL DRUG GY ","code_information":[{"code":"700123","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SNGL/INITL DRUG GY ","code_information":[{"code":"712094","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"IVP SNGL/INITL DRUG GY ","code_information":[{"code":"726094","type":"CDM"},{"code":"96374","type":"CPT"}],"standard_charges":[{"modifiers":"GY","modifiers_description":"Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit","setting":"outpatient","gross_charge":344.00,"discounted_cash":344.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":65.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":154.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":182.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":113.31,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":136.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":84.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":151.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":309.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":76.71,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":51.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":292.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":233.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":275.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":103.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":99.42,"methodology":"percent of total billed charges"}]}]},{"description":"JAK2 V617F VARIANT ","code_information":[{"code":"327085","type":"CDM"},{"code":"81270","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":127.25,"discounted_cash":127.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":24.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":24.18,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":57.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":67.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":41.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":55.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":114.53,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":28.38,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":19.09,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":108.16,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":86.53,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":36.78,"methodology":"percent of total billed charges"}]}]},{"description":"JO-1 ANTIBODY ","code_information":[{"code":"22780","type":"CDM"},{"code":"86235","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":19.75,"discounted_cash":19.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":8.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17.77,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.96,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16.79,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13.43,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5.71,"methodology":"percent of total billed charges"}]}]},{"description":"JOINT FNGR SWNSN MCP ","code_information":[{"code":"352366","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9300.00,"discounted_cash":9300.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4185.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4940.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3063.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8370.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7905.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7440.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2687.70,"methodology":"percent of total billed charges"}]}]},{"description":"JOINT TTL FEM RT XL ","code_information":[{"code":"175106","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23575.00,"discounted_cash":23575.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10608.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12523.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7765.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21217.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18860.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18860.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20038.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18860.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6813.18,"methodology":"percent of total billed charges"}]}]},{"description":"K-WIRE FX 2.3MM 150MM ","code_information":[{"code":"434161","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1666.00,"discounted_cash":1666.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":316.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":166.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":166.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":166.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":316.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":749.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":884.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":548.78,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":660.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":409.84,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":409.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":733.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1499.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":371.52,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1332.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2282.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":249.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":249.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1332.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1416.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1132.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1332.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":499.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1082.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1082.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1082.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":481.47,"methodology":"percent of total billed charges"}]}]},{"description":"KEEL PRS FIT 15MM ","code_information":[{"code":"171976","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4344.00,"discounted_cash":4344.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1954.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2307.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1430.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3909.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3475.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3475.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3692.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3475.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1255.42,"methodology":"percent of total billed charges"}]}]},{"description":"KETOROLAC 30 MG INJ ","drug_information":{"unit":"30","type":"ME"},"code_information":[{"code":"125509","type":"CDM"},{"code":"J1885","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":54.25,"discounted_cash":54.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":24.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":23.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":48.83,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":8.14,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":46.11,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15.68,"methodology":"percent of total billed charges"}]}]},{"description":"KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC ","code_information":[{"code":"660","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":31209.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16268.04,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":19835.83,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":13280.03,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":16932.04,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":25751.88,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":11620.03,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":26012.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":23406.06,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":16268.04,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17430.04,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":16600.04,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":26012.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":26012.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":16600.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":31209.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":11620.03,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":11620.03,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":11620.03,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC ","code_information":[{"code":"695","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":23115.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":13829.29,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":17665.45,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":11289.22,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":14393.75,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":22883.85,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":9878.06,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":23115.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":19897.24,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":13829.29,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":14817.10,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":14111.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":23115.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":23115.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":14111.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":9878.06,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":9878.06,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":9878.06,"methodology":"fee schedule"}]}]},{"description":"KIT ACCESSORY CONN ","code_information":[{"code":"25546","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":37425.66,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"KIT ANCHOR SPN 4CM ","code_information":[{"code":"383574","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9156.00,"discounted_cash":9156.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":915.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":915.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":915.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4120.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4863.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3015.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8240.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7324.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":12543.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7324.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7782.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7324.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5951.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5951.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5951.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2646.08,"methodology":"percent of total billed charges"}]}]},{"description":"KIT ARTH QCKSET SYR 16ML ","code_information":[{"code":"383132","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":46423.00,"discounted_cash":46423.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4642.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4642.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4642.30,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20890.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24659.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15291.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41780.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37138.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":63599.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37138.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":39459.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37138.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30174.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30174.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":30174.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13416.25,"methodology":"percent of total billed charges"}]}]},{"description":"KIT ARTHSCP FX ACL DISP ","code_information":[{"code":"384472","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":24411.00,"discounted_cash":24411.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4638.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2441.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2441.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2441.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4638.09,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10984.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12967.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8040.98,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":9671.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6005.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6005.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10740.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21969.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5443.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19528.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":33443.07,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3661.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3661.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19528.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20749.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":16599.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19528.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7323.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15867.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15867.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":15867.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7054.78,"methodology":"percent of total billed charges"}]}]},{"description":"KIT ASCP FX ACL DISP ","code_information":[{"code":"22360","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17946.00,"discounted_cash":17946.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3409.74,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1794.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1794.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1794.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3409.74,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8075.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9532.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5911.41,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":7110.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4414.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4414.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7896.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16151.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4001.96,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14356.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":24586.02,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2691.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2691.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14356.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15254.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":12203.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14356.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5383.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11664.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11664.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11664.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5186.39,"methodology":"percent of total billed charges"}]}]},{"description":"KIT BLN10GA 10MM ","code_information":[{"code":"388368","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":38158.00,"discounted_cash":38158.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7250.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3815.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3815.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3815.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7250.02,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17171.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20269.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12569.25,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":15118.20,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9386.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9386.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":16789.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":34342.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8509.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30526.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":52276.46,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5723.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5723.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30526.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32434.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":25947.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30526.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":11447.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24802.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24802.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24802.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11027.66,"methodology":"percent of total billed charges"}]}]},{"description":"KIT BNCMNT LATEX FREE ","code_information":[{"code":"388573","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":11818.00,"discounted_cash":11818.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1181.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1181.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1181.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5318.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6277.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3892.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10636.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9454.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":16190.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9454.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10045.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9454.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7681.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7681.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7681.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3415.40,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CASE SPN INSTR 4.2MM ","code_information":[{"code":"408768","type":"CDM"},{"code":"C1062","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CATH ART 18GA 16CM ","code_information":[{"code":"919600","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3933.00,"discounted_cash":3933.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":747.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":393.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":393.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":393.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":747.27,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1769.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2089.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1295.53,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1558.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":967.52,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":967.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1730.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3539.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":877.06,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3146.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5388.21,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":589.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":589.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3146.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3343.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2674.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3146.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1179.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2556.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2556.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2556.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1136.64,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CATH GW 18GA .038IN ","code_information":[{"code":"20916","type":"CDM"},{"code":"C1769","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2524.00,"discounted_cash":2524.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":479.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":479.56,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1135.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1340.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":831.41,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1000.01,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":620.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":620.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1110.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2271.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":562.85,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2019.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":378.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2019.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2145.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1716.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2019.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":757.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":729.44,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CATH RT HEART ","code_information":[{"code":"920793","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":365825.00,"discounted_cash":365825.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":69506.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36582.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36582.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36582.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":69506.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":164621.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":194326.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":120502.76,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":144939.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":89992.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":89992.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":160963.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":329242.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":81578.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":292660.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":501180.25,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":54873.75,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":54873.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":292660.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":310951.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":248761.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":292660.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":109747.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":237786.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":237786.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":237786.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":105723.43,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CHLGM CATH 20INCH ","code_information":[{"code":"430611","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1519.00,"discounted_cash":1519.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":288.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":151.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":151.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":151.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":288.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":683.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":806.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":500.36,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":601.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":373.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":373.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":668.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1367.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":338.74,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1215.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2081.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":227.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":227.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1215.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1291.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1032.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1215.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":455.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":987.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":987.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":987.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":438.99,"methodology":"percent of total billed charges"}]}]},{"description":"KIT CRTD SHNT 6IN ","code_information":[{"code":"388566","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1738.00,"discounted_cash":1738.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":330.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":173.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":173.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":173.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":330.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":782.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":923.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":572.50,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":688.60,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":427.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":427.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":764.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1564.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":387.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1390.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2381.06,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":260.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":260.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1390.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1477.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1181.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1390.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":521.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1129.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1129.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1129.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":502.28,"methodology":"percent of total billed charges"}]}]},{"description":"KIT DIALTOR INS OP ","code_information":[{"code":"390909","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":37425.66,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACETAB EP-108323 ","code_information":[{"code":"354971","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12124.00,"discounted_cash":12124.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5455.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6440.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3993.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10305.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3503.84,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACETB POLY 36MM ","code_information":[{"code":"410721","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB 20D +4 50-52M ","code_information":[{"code":"352386","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB 36X52MM ","code_information":[{"code":"172446","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB 62MM 36MM ","code_information":[{"code":"354723","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB CNTN TRLG32MM ","code_information":[{"code":"356088","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB CONTN 60X36MM ","code_information":[{"code":"358143","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10248.00,"discounted_cash":10248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4611.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5443.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3375.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9223.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8198.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8710.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8198.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2961.67,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HH OTHS 32MM ","code_information":[{"code":"350569","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11106.00,"discounted_cash":11106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4997.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5899.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3658.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9995.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9440.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8884.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3209.63,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 28/38MM ","code_information":[{"code":"920247","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 28X57MM ","code_information":[{"code":"359899","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6773.00,"discounted_cash":6773.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3047.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3597.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2231.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6095.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5418.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5418.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5757.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5418.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1957.40,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 36MM ","code_information":[{"code":"410804","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 36X52MM ","code_information":[{"code":"355426","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 44/58MM ","code_information":[{"code":"389470","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20788.00,"discounted_cash":20788.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9354.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11042.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6847.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18709.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16630.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16630.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17669.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16630.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6007.73,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 50MM ","code_information":[{"code":"388173","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7881.00,"discounted_cash":7881.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3546.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4186.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2596.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7092.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6698.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6304.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2277.61,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP 56X36MM ","code_information":[{"code":"384709","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP J 36MM ","code_information":[{"code":"438801","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP SZB 32MM ","code_information":[{"code":"389571","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP SZE 36MM ","code_information":[{"code":"428201","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB HIP10D36X52MM ","code_information":[{"code":"173329","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11518.00,"discounted_cash":11518.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5183.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6118.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3794.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9790.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9214.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3328.70,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB KK P6.3 56X35 ","code_information":[{"code":"350711","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB OD 44MM R3 ","code_information":[{"code":"354031","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB SIZE G 36MM ","code_information":[{"code":"388804","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB SZF 36MM ","code_information":[{"code":"355992","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12124.00,"discounted_cash":12124.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5455.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6440.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3993.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10305.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9699.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3503.84,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB SZI 40MM ","code_information":[{"code":"438799","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER ACTB XLNK 2X36MM ","code_information":[{"code":"352432","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER BIP HIP 22MM ","code_information":[{"code":"21562","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4034.00,"discounted_cash":4034.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1815.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2142.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1328.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3630.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3227.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3227.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3428.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3227.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1165.83,"methodology":"percent of total billed charges"}]}]},{"description":"LINER CMPNT HIP 50X32MM ","code_information":[{"code":"430926","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER HIP 20D 36X54MM ","code_information":[{"code":"355339","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER HIP 48MM ","code_information":[{"code":"389799","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9882.00,"discounted_cash":9882.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4446.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5249.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3255.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8893.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8399.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2855.90,"methodology":"percent of total billed charges"}]}]},{"description":"LINER HIP D 22MM 38MM ","code_information":[{"code":"390741","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9093.00,"discounted_cash":9093.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4091.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4830.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2995.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7729.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7274.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2627.88,"methodology":"percent of total billed charges"}]}]},{"description":"LINER HIP SZH 52MM ","code_information":[{"code":"920106","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9882.00,"discounted_cash":9882.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4446.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5249.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3255.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8893.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8399.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7905.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2855.90,"methodology":"percent of total billed charges"}]}]},{"description":"LINER RNGLC XL 36 SZ24 ","code_information":[{"code":"171727","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINER XLPE 20X54-56X36 ","code_information":[{"code":"174744","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7527.00,"discounted_cash":7527.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3387.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3998.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2479.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6774.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6397.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6021.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2175.30,"methodology":"percent of total billed charges"}]}]},{"description":"LINR ACT R3 58MM CONSTRN ","code_information":[{"code":"384285","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"LIPID EMULSION 20% INJ ","code_information":[{"code":"128354","type":"CDM"},{"code":"J3490","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":334.00,"discounted_cash":334.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":63.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":63.46,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":150.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":177.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":110.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":82.16,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":82.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":146.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":300.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":74.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":267.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":50.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":267.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":283.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":227.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":267.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":100.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":96.53,"methodology":"percent of total billed charges"}]}]},{"description":"LIPOSYN 20% 1 ML ","code_information":[{"code":"126478","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10.50,"discounted_cash":10.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3.46,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9.45,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.34,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14.38,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.57,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.93,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7.14,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6.83,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6.83,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3.03,"methodology":"percent of total billed charges"}]}]},{"description":"LITHIUM CARB 150 MG PO ","code_information":[{"code":"128514","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3.50,"discounted_cash":3.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.67,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.35,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.67,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3.15,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":0.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4.79,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.53,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.53,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2.98,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2.38,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.27,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.27,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2.27,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT WITHOUT MCC ","code_information":[{"code":"006","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":93482.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":67599.52,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":46200.75,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":58905.96,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":92547.18,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":40425.66,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"Emerging Therapy Solutions","plan_name":"MCD","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":"First Health ","plan_name":"COMM","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":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":93482.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":81428.83,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":60638.49,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":57750.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 7. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":93482.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":93482.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":57750.94,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":40425.66,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":40425.66,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":40425.66,"methodology":"fee schedule"}]}]},{"description":"LNR ACTB CBLT CHR ","code_information":[{"code":"26152","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12731.00,"discounted_cash":12731.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5728.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6762.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4193.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11457.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10821.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10184.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3679.26,"methodology":"percent of total billed charges"}]}]},{"description":"LOCAL ANESTHESIA ","code_information":[{"code":"230145","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2333.25,"discounted_cash":2333.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":443.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":233.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":233.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":233.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":443.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1049.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1239.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":768.57,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":924.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":573.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":573.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1026.63,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2099.93,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":520.31,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1866.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3196.55,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":349.99,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":349.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1866.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1983.26,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1586.61,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1866.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":699.98,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1516.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1516.61,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1516.61,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":674.31,"methodology":"percent of total billed charges"}]}]},{"description":"LOCM 300-399 IC 100ML ","drug_information":{"unit":"100","type":"ML"},"code_information":[{"code":"125605","type":"CDM"},{"code":"Q9967","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":492.00,"discounted_cash":492.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":221.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":216.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":442.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":393.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":73.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":393.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":418.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":393.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":142.19,"methodology":"percent of total billed charges"}]}]},{"description":"LOCM 300-399 IC 200ML ","drug_information":{"unit":"200","type":"ML"},"code_information":[{"code":"127978","type":"CDM"},{"code":"Q9967","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":245.50,"discounted_cash":245.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":110.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":108.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":220.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":196.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":36.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":196.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":208.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":196.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":70.95,"methodology":"percent of total billed charges"}]}]},{"description":"LOPERAMIDE 1 MG/7.5ML OS ","code_information":[{"code":"127962","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14.00,"discounted_cash":14.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.66,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.66,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4.61,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3.12,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":19.18,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.10,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11.90,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4.05,"methodology":"percent of total billed charges"}]}]},{"description":"LORAZEPAM 2 MG INJ ","drug_information":{"unit":"2","type":"ME"},"code_information":[{"code":"126343","type":"CDM"},{"code":"J2060","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18.00,"discounted_cash":18.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5.20,"methodology":"percent of total billed charges"}]}]},{"description":"LOSARTAN 25MG TAB ","code_information":[{"code":"120057","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27.50,"discounted_cash":27.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9.06,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":37.67,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.13,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23.38,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.95,"methodology":"percent of total billed charges"}]}]},{"description":"LT MINERAL OIL STER 10ML ","code_information":[{"code":"127128","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":90.50,"discounted_cash":90.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":17.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":17.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":40.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":48.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":29.81,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":35.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":22.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":39.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":81.45,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":20.18,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":72.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":123.98,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":13.57,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":13.57,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":72.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":76.92,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":61.54,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":72.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":27.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":58.83,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":58.83,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":58.83,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":26.15,"methodology":"percent of total billed charges"}]}]},{"description":"LURASIDONE 40 MG PO ","code_information":[{"code":"128295","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":200.25,"discounted_cash":200.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":38.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":38.05,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":90.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":106.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":65.96,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":79.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":49.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":49.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":88.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":180.22,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":44.66,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":274.34,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":30.04,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":30.04,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":170.21,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":136.17,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":160.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":60.08,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.16,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.16,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.16,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":57.87,"methodology":"percent of total billed charges"}]}]},{"description":"LVL 3 HOSP TYPE B ED VST ","code_information":[{"code":"79283","type":"CDM"},{"code":"G0382","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2087.50,"discounted_cash":2087.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":939.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":918.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1878.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1670.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1670.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1774.38,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1419.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":603.29,"methodology":"percent of total billed charges"}]}]},{"description":"LYMPH TRANSFORM ","code_information":[{"code":"372036","type":"CDM"},{"code":"86353","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":237.25,"discounted_cash":237.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":45.08,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":45.08,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":106.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":104.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":213.53,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":52.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":189.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":35.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":189.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":201.66,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":161.33,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":189.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":68.57,"methodology":"percent of total billed charges"}]}]},{"description":"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"825","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":27369.48,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":15013.04,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":27369.48,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":12255.54,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":15625.82,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":24708.42,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":10723.60,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":24958.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":21600.40,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":15013.04,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16085.40,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":15319.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":24958.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":24958.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":15319.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":10723.60,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":10723.60,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":10723.60,"methodology":"fee schedule"}]}]},{"description":"MAG CIT SOLN 300ML ","code_information":[{"code":"120728","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":11.00,"discounted_cash":11.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.09,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3.62,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.45,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":15.07,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3.18,"methodology":"percent of total billed charges"}]}]},{"description":"MAG SULFATE 20G INJ ","drug_information":{"unit":"20","type":"GM"},"code_information":[{"code":"127772","type":"CDM"},{"code":"J3475","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":113.25,"discounted_cash":113.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":50.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":49.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":101.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":16.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":96.26,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":32.73,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNESIUM URINE ","code_information":[{"code":"371180","type":"CDM"},{"code":"83735","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":7.50,"discounted_cash":7.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.43,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.43,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.67,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6.38,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"}]}]},{"description":"MAJOR CHEST TRAUMA WITH MCC ","code_information":[{"code":"183","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":30430.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":19110.19,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":23109.84,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":15600.15,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":19890.19,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":30125.70,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":13650.13,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":30430.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":27495.27,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":19110.19,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":20475.20,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":19500.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":30430.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":30430.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":19500.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":13650.13,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":13650.13,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":13650.13,"methodology":"fee schedule"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITH CC ","code_information":[{"code":"141","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":40039.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":25558.74,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":31381.43,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":20864.28,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":26601.96,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":39638.61,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":18256.24,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":40039.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":36773.29,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":25558.74,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":27384.37,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":26080.35,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":40039.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":40039.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":26080.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":18256.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":18256.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":18256.24,"methodology":"fee schedule"}]}]},{"description":"MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES ","code_information":[{"code":"483","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":48012.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":30153.52,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":33138.43,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":24615.12,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":31384.28,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":47531.88,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":21538.23,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":48012.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":43384.15,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":30153.52,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":32307.35,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":30768.90,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":48012.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":48012.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":30768.90,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":21538.23,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":21538.23,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":21538.23,"methodology":"fee schedule"}]}]},{"description":"MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC ","code_information":[{"code":"329","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":87296.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":53640.01,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":64985.10,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":43787.76,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":55829.39,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":86423.04,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":38314.29,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":87296.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":77175.93,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":53640.01,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":57471.43,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":54734.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 9. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":87296.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":87296.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":54734.70,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":38314.29,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":38314.29,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":38314.29,"methodology":"fee schedule"}]}]},{"description":"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ","code_information":[{"code":"756","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":19127.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":11843.35,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":15334.77,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":9668.04,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":12326.75,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":18935.73,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":8459.53,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":19127.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":17039.92,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":11843.35,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":12689.30,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":12085.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":19127.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":19127.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":12085.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":8459.53,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":8459.53,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":8459.53,"methodology":"fee schedule"}]}]},{"description":"MAMMO DIAG CAD BI ","code_information":[{"code":"257066","type":"CDM"},{"code":"77066","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1488.00,"discounted_cash":1488.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":282.72,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":282.72,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":669.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":654.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1339.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":331.82,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1190.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":223.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1190.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1264.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1011.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1190.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":446.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":430.03,"methodology":"percent of total billed charges"}]}]},{"description":"MANIPULATOR ENDO DX ","code_information":[{"code":"434219","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2757.00,"discounted_cash":2757.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":523.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":275.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":523.83,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1240.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1464.52,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":908.16,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1092.32,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":678.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":678.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1213.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2481.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":614.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2205.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3777.09,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":413.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":413.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2205.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2343.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1874.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2205.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":827.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1792.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1792.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1792.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":796.77,"methodology":"percent of total billed charges"}]}]},{"description":"MANUAL THER TECH 15M PT ","code_information":[{"code":"620165","type":"CDM"},{"code":"97140","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":736.00,"discounted_cash":736.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":139.84,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":139.84,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":331.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":291.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":323.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":662.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":164.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":588.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":110.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":588.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":625.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":500.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":588.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":212.70,"methodology":"percent of total billed charges"}]}]},{"description":"MARKER FID EXT 10MM ","code_information":[{"code":"182577","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2091.00,"discounted_cash":2091.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":397.29,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":209.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":209.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":209.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":397.29,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":940.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1110.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":688.78,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":828.45,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":514.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":514.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":920.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1881.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":466.29,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1672.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2864.67,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":313.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":313.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1672.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1777.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1421.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1672.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":627.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1359.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1359.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1359.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":604.30,"methodology":"percent of total billed charges"}]}]},{"description":"MARKER TISS 8GA ","code_information":[{"code":"428503","type":"CDM"},{"code":"A4648","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1821.00,"discounted_cash":1821.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":819.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":967.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":599.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1638.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1456.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1456.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1547.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1456.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":526.27,"methodology":"percent of total billed charges"}]}]},{"description":"MASSAGE 15 MIN PT ","code_information":[{"code":"620115","type":"CDM"},{"code":"97124","type":"CPT"}],"standard_charges":[{"modifiers":"GP","modifiers_description":"Services delivered under an outpatient physical therapy plan of care","setting":"outpatient","gross_charge":522.50,"discounted_cash":522.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":99.28,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":99.28,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":235.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":207.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":229.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":470.25,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":116.52,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":418.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":78.38,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":418.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":444.13,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":355.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":418.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":151.00,"methodology":"percent of total billed charges"}]}]},{"description":"MATRIX BN DEMENRLZD 10CC ","code_information":[{"code":"388839","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":9821.00,"discounted_cash":9821.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":982.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":982.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":982.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4419.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5216.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3235.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8838.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7856.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":13454.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7856.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8347.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7856.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6383.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6383.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6383.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2838.27,"methodology":"percent of total billed charges"}]}]},{"description":"MATRIX TISS 30X20CM ","code_information":[{"code":"430409","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":156069.00,"discounted_cash":156069.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":70231.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":82903.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":51409.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":140462.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":124855.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":124855.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":132658.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":124855.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":45103.94,"methodology":"percent of total billed charges"}]}]},{"description":"MCATH INFSN 2.6FR 150CM ","code_information":[{"code":"389552","type":"CDM"},{"code":"C1751","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21716.00,"discounted_cash":21716.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4126.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4126.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9772.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11535.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7153.25,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8603.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5342.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5342.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9555.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19544.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4842.67,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3257.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18458.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14766.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6514.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6275.92,"methodology":"percent of total billed charges"}]}]},{"description":"MCTH INFS 20CM 115CM ","code_information":[{"code":"279765","type":"CDM"},{"code":"C1887","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"MED LT FEM ORTHOSOURCE ","code_information":[{"code":"21322","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20611.00,"discounted_cash":20611.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9274.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10948.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6789.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18549.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17519.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16488.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5956.58,"methodology":"percent of total billed charges"}]}]},{"description":"MEDTRONIC BALLOON ","code_information":[{"code":"465527","type":"CDM"},{"code":"C1725","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1143.00,"discounted_cash":1143.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":217.17,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":217.17,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":514.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":607.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":376.50,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":452.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":281.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":281.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":502.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1028.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":254.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":171.45,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":971.55,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":777.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":342.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":330.33,"methodology":"percent of total billed charges"}]}]},{"description":"MEMBRANE AMNIO 2CC MD ","code_information":[{"code":"354093","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":25419.00,"discounted_cash":25419.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2541.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2541.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2541.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11438.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13502.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8373.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22877.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20335.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":34824.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20335.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21606.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20335.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16522.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16522.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16522.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7346.09,"methodology":"percent of total billed charges"}]}]},{"description":"MEPERIDINE 100 MG INJ ","drug_information":{"unit":"100","type":"ME"},"code_information":[{"code":"124124","type":"CDM"},{"code":"J2175","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":44.00,"discounted_cash":44.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":19.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":39.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":37.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12.72,"methodology":"percent of total billed charges"}]}]},{"description":"MEPIVACAIN 2% 20 ML INJ ","drug_information":{"unit":"20","type":"ML"},"code_information":[{"code":"125832","type":"CDM"},{"code":"J0670","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":160.50,"discounted_cash":160.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":72.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":70.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":144.45,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":128.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":24.07,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":128.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":136.43,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":128.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":46.38,"methodology":"percent of total billed charges"}]}]},{"description":"MEROPENEM 50 MG/ML INJ ","drug_information":{"unit":"50","type":"ME"},"code_information":[{"code":"126889","type":"CDM"},{"code":"J2185","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":33.75,"discounted_cash":33.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":15.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":14.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":30.38,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28.69,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9.75,"methodology":"percent of total billed charges"}]}]},{"description":"MESALAMINE 400 MG CAP ","code_information":[{"code":"126614","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":26.25,"discounted_cash":26.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.99,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.99,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8.65,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.46,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":11.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23.63,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5.85,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":35.96,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.94,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22.31,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":17.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.06,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.59,"methodology":"percent of total billed charges"}]}]},{"description":"MESH DANEK 015.2001.4 ","code_information":[{"code":"356139","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10287.00,"discounted_cash":10287.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4629.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5464.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3388.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9258.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8229.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8743.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8229.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2972.94,"methodology":"percent of total billed charges"}]}]},{"description":"MESH HERNIA 15X9MM ","code_information":[{"code":"383333","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10429.00,"discounted_cash":10429.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4693.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5539.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3435.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9386.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8343.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8343.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8864.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8343.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3013.98,"methodology":"percent of total billed charges"}]}]},{"description":"MESH HRN GRN 10X14IN ","code_information":[{"code":"382545","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"MESH HRN PLGLY 10X6CM ","code_information":[{"code":"429901","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12763.00,"discounted_cash":12763.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5743.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6779.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4204.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11486.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10210.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10210.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10848.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10210.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3688.51,"methodology":"percent of total billed charges"}]}]},{"description":"MESH HRN PP 12X10IN ","code_information":[{"code":"387376","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26098.00,"discounted_cash":26098.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11744.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13863.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8596.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23488.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20878.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20878.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22183.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20878.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7542.32,"methodology":"percent of total billed charges"}]}]},{"description":"MESH HRN RSRB 10X20CM ","code_information":[{"code":"389507","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":50893.00,"discounted_cash":50893.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22901.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":27034.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16764.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":45803.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40714.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40714.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43259.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":40714.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14708.08,"methodology":"percent of total billed charges"}]}]},{"description":"MESH PERM CIRC 15X20CM ","code_information":[{"code":"438063","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":56384.00,"discounted_cash":56384.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":25372.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":29951.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":18572.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":50745.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45107.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45107.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":47926.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45107.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":16294.98,"methodology":"percent of total billed charges"}]}]},{"description":"MESH PORCINE 10CM 20CM ","code_information":[{"code":"390207","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":76257.00,"discounted_cash":76257.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":34315.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":40507.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":25119.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":68631.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":61005.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":61005.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":64818.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":61005.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22038.27,"methodology":"percent of total billed charges"}]}]},{"description":"MESH PROCINE 10CM 16CM ","code_information":[{"code":"390206","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30503.00,"discounted_cash":30503.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13726.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16203.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10047.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27452.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24402.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24402.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25927.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24402.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8815.37,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG 10CM 17CM ","code_information":[{"code":"435477","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8273.00,"discounted_cash":8273.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3722.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4394.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2725.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7445.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6618.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6618.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7032.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6618.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2390.90,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG 20X15CM ","code_information":[{"code":"355516","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG 3IN 5IN ","code_information":[{"code":"387183","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG 9CM PRTX VNTRL ","code_information":[{"code":"355050","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5913.00,"discounted_cash":5913.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2660.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3140.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1947.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5321.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4730.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4730.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5026.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4730.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1708.86,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG HRN 25X20CM ","code_information":[{"code":"354783","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10377.00,"discounted_cash":10377.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4669.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5512.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3418.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9339.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8820.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8301.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2998.95,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG PATCH 6.5CM ","code_information":[{"code":"355027","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2023.00,"discounted_cash":2023.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":910.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1074.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":666.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1820.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1618.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1618.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1719.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1618.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":584.65,"methodology":"percent of total billed charges"}]}]},{"description":"MESH SURG SPNL 20X17 ","code_information":[{"code":"357938","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":70704.00,"discounted_cash":70704.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31816.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":37557.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":23289.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":63633.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60098.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":20433.46,"methodology":"percent of total billed charges"}]}]},{"description":"MESNA 400 MG TAB ","code_information":[{"code":"126336","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":629.00,"discounted_cash":629.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":119.51,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":62.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":62.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":62.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":119.51,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":283.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":334.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":207.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":154.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":154.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":276.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":566.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":140.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":503.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":861.73,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":94.35,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":94.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":503.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":534.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":427.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":503.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":188.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":408.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":408.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":408.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":181.78,"methodology":"percent of total billed charges"}]}]},{"description":"METFORMIN SR 750MG TAB ","code_information":[{"code":"126259","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":26.00,"discounted_cash":26.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.94,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.94,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8.56,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":11.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":5.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":35.62,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":17.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":7.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.51,"methodology":"percent of total billed charges"}]}]},{"description":"METHOCARBAM 1G/10ML INJ ","drug_information":{"unit":"10","type":"ML"},"code_information":[{"code":"126897","type":"CDM"},{"code":"J2800","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":839.00,"discounted_cash":839.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":377.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":369.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":755.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":125.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":713.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":242.47,"methodology":"percent of total billed charges"}]}]},{"description":"METHOTREXATE RHEUMAT QN ","code_information":[{"code":"371205","type":"CDM"},{"code":"80204","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":16.50,"discounted_cash":16.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14.85,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3.68,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14.03,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":11.22,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4.77,"methodology":"percent of total billed charges"}]}]},{"description":"METHYLPHENIDATE 5MG TAB ","code_information":[{"code":"120696","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21.25,"discounted_cash":21.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8.42,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4.74,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29.11,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6.14,"methodology":"percent of total billed charges"}]}]},{"description":"METHYLPRED SS 40 MG INJ ","drug_information":{"unit":"40","type":"ME"},"code_information":[{"code":"128503","type":"CDM"},{"code":"J2919","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":47.75,"discounted_cash":47.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.78,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":21.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":42.98,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":65.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.16,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.16,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":40.59,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.04,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.04,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.04,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13.80,"methodology":"percent of total billed charges"}]}]},{"description":"METOLAZONE 10MG TAB ","code_information":[{"code":"120257","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":30.50,"discounted_cash":30.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.05,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10.05,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":12.08,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":7.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27.45,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":41.78,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.58,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.58,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25.93,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":20.74,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":9.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19.82,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19.82,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":19.82,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8.81,"methodology":"percent of total billed charges"}]}]},{"description":"METRONIDAZOLE 250 MG INJ ","code_information":[{"code":"125658","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":38.50,"discounted_cash":38.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.32,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.85,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.85,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.85,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.32,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12.68,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":16.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":34.65,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8.59,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":52.74,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.78,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.78,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32.73,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":26.18,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":11.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25.02,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25.02,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11.13,"methodology":"percent of total billed charges"}]}]},{"description":"MEXILETINE 200MG CAP ","code_information":[{"code":"120703","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":18.00,"discounted_cash":18.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5.93,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":7.13,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":7.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4.01,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":24.66,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":12.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5.20,"methodology":"percent of total billed charges"}]}]},{"description":"MICAFUNGIN 100 MG INJ ","drug_information":{"unit":"100","type":"ME"},"code_information":[{"code":"125330","type":"CDM"},{"code":"J2248","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2464.75,"discounted_cash":2464.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1109.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1084.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2218.28,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1971.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":369.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1971.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2095.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1971.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":712.31,"methodology":"percent of total billed charges"}]}]},{"description":"MICONAZOLE NT 2% CREAM ","code_information":[{"code":"127093","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":51.50,"discounted_cash":51.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":27.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16.96,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":20.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":12.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":12.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":22.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":46.35,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":11.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":70.56,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43.77,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":35.02,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":15.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":33.48,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":33.48,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":33.48,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14.88,"methodology":"percent of total billed charges"}]}]},{"description":"MID-LINE CATHETER PLCMNT ","code_information":[{"code":"36410","type":"CPT"},{"code":"746106","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":837.50,"discounted_cash":837.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":376.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":331.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":368.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":753.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":186.76,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":670.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":670.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":711.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":242.04,"methodology":"percent of total billed charges"}]}]},{"description":"MIDAZOLAM 5 MG OS ","code_information":[{"code":"128268","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":35.75,"discounted_cash":35.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.58,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.79,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16.09,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11.78,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.79,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":15.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32.17,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":48.98,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.36,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":30.39,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":24.31,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":10.72,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":23.24,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":23.24,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":23.24,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10.33,"methodology":"percent of total billed charges"}]}]},{"description":"MILK OF MAGNESIA 30ML ","code_information":[{"code":"120291","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1.00,"discounted_cash":1.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.19,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.19,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":0.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":0.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":0.33,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":0.40,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":0.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":0.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":0.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":0.22,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1.37,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.15,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":0.85,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":0.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":0.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":0.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":0.65,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":0.29,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL 32CM LT INTERTAN ","code_information":[{"code":"354189","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":40993.00,"discounted_cash":40993.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18446.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":21775.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":13503.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":36893.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":34844.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32794.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11846.98,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL 8 42CM TIB NLEX IM ","code_information":[{"code":"358977","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL 9MM 18CM HIP FEM ","code_information":[{"code":"175025","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19647.00,"discounted_cash":19647.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8841.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10436.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6471.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17682.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16699.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5677.98,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL 9X360MM META LEFT ","code_information":[{"code":"383012","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23887.00,"discounted_cash":23887.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10749.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12688.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7868.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21498.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20303.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6903.34,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 1.5 130D 11.5X44 ","code_information":[{"code":"407992","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25361.00,"discounted_cash":25361.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11412.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13471.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8353.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22824.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20288.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20288.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21556.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20288.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7329.33,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 10MM 235MM ","code_information":[{"code":"357387","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24610.00,"discounted_cash":24610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11074.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13072.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8106.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22149.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20918.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7112.29,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 10MM 315MM ","code_information":[{"code":"914664","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24075.00,"discounted_cash":24075.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10833.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12788.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7930.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21667.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20463.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6957.68,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 10MM 360MM ","code_information":[{"code":"391243","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24495.00,"discounted_cash":24495.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11022.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13011.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8068.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22045.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20820.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7079.06,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 10MM 400MM ","code_information":[{"code":"414809","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17934.00,"discounted_cash":17934.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8070.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9526.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5907.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16140.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15243.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5182.93,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 11.5MM 18CM ","code_information":[{"code":"914540","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18341.00,"discounted_cash":18341.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8253.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9742.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6041.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16506.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14672.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14672.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15589.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14672.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5300.55,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 11MM 180MM ","code_information":[{"code":"175072","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19647.00,"discounted_cash":19647.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8841.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10436.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6471.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17682.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16699.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15717.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5677.98,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 11MM 36CM ","code_information":[{"code":"387003","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20641.00,"discounted_cash":20641.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9288.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10964.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6799.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18576.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17544.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5965.25,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 11X315MM ","code_information":[{"code":"914642","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17934.00,"discounted_cash":17934.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8070.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9526.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5907.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16140.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15243.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5182.93,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 125D 11MM 400MM ","code_information":[{"code":"388783","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24123.00,"discounted_cash":24123.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10855.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12814.14,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7946.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21710.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19298.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19298.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20504.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19298.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6971.55,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 12MM 340MM ","code_information":[{"code":"390833","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22275.00,"discounted_cash":22275.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10023.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11832.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7337.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20047.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18933.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6437.48,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 12X440MM ","code_information":[{"code":"388098","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25981.00,"discounted_cash":25981.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11691.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13801.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8558.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23382.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22083.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7508.51,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 130D 12MM 235MM ","code_information":[{"code":"388087","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24610.00,"discounted_cash":24610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11074.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13072.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8106.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22149.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20918.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19688.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7112.29,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 13MM 21.5CM ","code_information":[{"code":"353546","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21147.00,"discounted_cash":21147.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9516.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11233.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6965.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19032.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16917.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16917.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17974.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16917.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6111.48,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 2.5MM 440MM ","code_information":[{"code":"21935","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 5D 12X340MM ","code_information":[{"code":"391200","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22373.00,"discounted_cash":22373.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10067.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11884.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7369.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20135.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17898.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17898.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19017.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17898.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6465.80,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN 9.5MM 11MM 160MM ","code_information":[{"code":"387597","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17641.00,"discounted_cash":17641.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7938.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9370.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5810.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15876.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14112.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14112.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14994.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14112.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5098.25,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN BENT 8/7MM 16CM ","code_information":[{"code":"174995","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21653.00,"discounted_cash":21653.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9743.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11502.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7132.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19487.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18405.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17322.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6257.72,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 10MM 340MM ","code_information":[{"code":"390928","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24495.00,"discounted_cash":24495.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11022.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13011.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8068.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22045.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20820.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7079.06,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 10MM 38CM ","code_information":[{"code":"351337","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22903.00,"discounted_cash":22903.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10306.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12166.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7544.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20612.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19467.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6618.97,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 10X420MM ","code_information":[{"code":"411665","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17934.00,"discounted_cash":17934.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8070.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9526.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5907.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16140.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15243.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5182.93,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 11MM 340MM ","code_information":[{"code":"357241","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28274.00,"discounted_cash":28274.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12723.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15019.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9313.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25446.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24032.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8171.19,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 11X220MM ","code_information":[{"code":"428935","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19307.00,"discounted_cash":19307.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8688.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10255.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6359.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17376.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16410.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5579.72,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 12MM 360MM ","code_information":[{"code":"391049","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24495.00,"discounted_cash":24495.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11022.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13011.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8068.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22045.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20820.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19596.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7079.06,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 13X400MM ","code_information":[{"code":"919219","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19307.00,"discounted_cash":19307.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8688.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10255.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6359.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17376.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16410.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15445.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5579.72,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 9MM 380MM ","code_information":[{"code":"390683","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25981.00,"discounted_cash":25981.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11691.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13801.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8558.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23382.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22083.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7508.51,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM RT 14X380MM ","code_information":[{"code":"389791","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28274.00,"discounted_cash":28274.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12723.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15019.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9313.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25446.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24032.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22619.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8171.19,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN GT RT 12X420MM ","code_information":[{"code":"412376","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17934.00,"discounted_cash":17934.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8070.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9526.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5907.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16140.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15243.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5182.93,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 130D 10MM ","code_information":[{"code":"358298","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21403.00,"discounted_cash":21403.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9631.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11369.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7050.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19262.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17122.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17122.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18192.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17122.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6185.47,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM 9MM 33CM ","code_information":[{"code":"350317","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13829.00,"discounted_cash":13829.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6223.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7345.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4555.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12446.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11754.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3996.58,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEM RT 10X420MM ","code_information":[{"code":"388414","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22275.00,"discounted_cash":22275.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10023.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11832.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7337.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20047.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18933.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17820.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6437.48,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN FEMCANN 13X400MM ","code_information":[{"code":"174584","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15671.00,"discounted_cash":15671.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7051.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8324.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5162.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14103.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12536.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12536.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13320.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12536.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4528.92,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN HUM 8MM 150MM ","code_information":[{"code":"390175","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21208.00,"discounted_cash":21208.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9543.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11265.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6985.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19087.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18026.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16966.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6129.11,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN LCK 10MM 26CM ","code_information":[{"code":"390174","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20641.00,"discounted_cash":20641.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9288.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10964.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6799.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18576.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17544.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16512.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5965.25,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN LT 125D 13X400MM ","code_information":[{"code":"390800","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26778.00,"discounted_cash":26778.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12050.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14224.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8820.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24100.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22761.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7738.84,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN LT 9X340MM 8HL ","code_information":[{"code":"386946","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29958.00,"discounted_cash":29958.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13481.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15913.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9868.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26962.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25464.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8657.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN RT 11.5MM 36CM ","code_information":[{"code":"354168","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29874.00,"discounted_cash":29874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15869.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9840.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26886.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25392.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8633.59,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TIB 10MM 33CM ","code_information":[{"code":"175246","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13829.00,"discounted_cash":13829.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6223.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7345.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4555.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12446.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11754.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11063.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3996.58,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TIB 11MM 300MM ","code_information":[{"code":"351840","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TIB 8.5MM 26CM ","code_information":[{"code":"354753","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22187.00,"discounted_cash":22187.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9984.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11785.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7308.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19968.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18858.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6412.04,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TIB IM 9X375MM ","code_information":[{"code":"386531","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18767.00,"discounted_cash":18767.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8445.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9969.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6181.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16890.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15013.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15013.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15951.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15013.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5423.66,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TROCH 10MM 34CM ","code_information":[{"code":"381195","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29874.00,"discounted_cash":29874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15869.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9840.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26886.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25392.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8633.59,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL BN TROCH 11.5M 20CM ","code_information":[{"code":"389107","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24172.00,"discounted_cash":24172.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10877.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12840.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7962.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21754.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19337.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19337.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20546.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19337.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6985.71,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL CPHMDLRY11.5MM 36CM ","code_information":[{"code":"355309","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31828.00,"discounted_cash":31828.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14322.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16907.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10484.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28645.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27053.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9198.29,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 10MM 340MM ","code_information":[{"code":"25434","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14875.00,"discounted_cash":14875.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6693.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7901.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4899.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13387.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12643.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4298.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 10MM 400MM ","code_information":[{"code":"386329","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29958.00,"discounted_cash":29958.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13481.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15913.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9868.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26962.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25464.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8657.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 11MM 320MM ","code_information":[{"code":"23755","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19740.00,"discounted_cash":19740.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8883.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10485.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6502.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17766.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16779.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5704.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 11MM 420MM ","code_information":[{"code":"385833","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29958.00,"discounted_cash":29958.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13481.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15913.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9868.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26962.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25464.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23966.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8657.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 12MM 380MM ","code_information":[{"code":"25515","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14875.00,"discounted_cash":14875.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6693.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7901.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4899.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13387.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12643.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4298.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 12X300MM ","code_information":[{"code":"915955","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17934.00,"discounted_cash":17934.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8070.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9526.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5907.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16140.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15243.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14347.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5182.93,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 13MM 420MM ","code_information":[{"code":"390381","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25981.00,"discounted_cash":25981.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11691.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13801.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8558.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23382.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22083.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20784.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7508.51,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM 8.5X34CM ","code_information":[{"code":"22105","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16965.00,"discounted_cash":16965.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7634.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9011.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5588.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15268.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13572.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13572.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14420.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13572.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4902.89,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM CANN 10MM 340MM ","code_information":[{"code":"357853","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28151.00,"discounted_cash":28151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12667.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14953.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9272.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25335.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23928.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8135.64,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM CANN 10MM 440MM ","code_information":[{"code":"380292","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28151.00,"discounted_cash":28151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12667.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14953.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9272.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25335.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23928.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8135.64,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM CANN 11MM 420MM ","code_information":[{"code":"358653","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28151.00,"discounted_cash":28151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12667.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14953.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9272.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25335.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23928.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22520.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8135.64,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM LAT LT 10X340MM ","code_information":[{"code":"22146","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18923.00,"discounted_cash":18923.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8515.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10051.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6233.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17030.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15138.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15138.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16084.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15138.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5468.75,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM LT 11.5MM 42CM ","code_information":[{"code":"384747","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29874.00,"discounted_cash":29874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15869.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9840.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26886.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25392.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8633.59,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM META RTRO 10X34 ","code_information":[{"code":"352733","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22903.00,"discounted_cash":22903.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10306.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12166.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7544.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20612.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19467.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18322.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6618.97,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM RETGRD 10MM ","code_information":[{"code":"175219","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":30081.00,"discounted_cash":30081.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13536.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15979.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9908.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27072.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24064.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24064.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25568.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24064.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8693.41,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM RT 10X400MM ","code_information":[{"code":"171742","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19285.00,"discounted_cash":19285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8678.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10244.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6352.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17356.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16392.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5573.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM RT PHNX10.5X360 ","code_information":[{"code":"352683","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36683.00,"discounted_cash":36683.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16507.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19486.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12083.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33014.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31180.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29346.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10601.39,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEM TAN LF 10X36 ","code_information":[{"code":"174395","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19340.00,"discounted_cash":19340.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8703.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10273.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6370.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17406.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15472.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15472.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16439.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15472.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5589.26,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL FEMORAL 04.013.736S ","code_information":[{"code":"351851","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19740.00,"discounted_cash":19740.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8883.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10485.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6502.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17766.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16779.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5704.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL HIP FX RT 11X130MM ","code_information":[{"code":"352292","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25925.00,"discounted_cash":25925.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11666.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13771.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8539.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23332.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20740.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20740.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22036.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20740.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7492.32,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL HUM 2.5MM 450MM ","code_information":[{"code":"391141","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5360.00,"discounted_cash":5360.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2412.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2847.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1765.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4824.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4288.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4556.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4288.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1549.04,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL HUM CANN 9MM 150MM ","code_information":[{"code":"23552","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22067.00,"discounted_cash":22067.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9930.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11721.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7268.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19860.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18756.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6377.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL HUMERAL 9X220MM ","code_information":[{"code":"171657","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22067.00,"discounted_cash":22067.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9930.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11721.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7268.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19860.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18756.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6377.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM CANN TIB 9MMX300 ","code_information":[{"code":"174233","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM L230MM OD9MM PRO ","code_information":[{"code":"351785","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22067.00,"discounted_cash":22067.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9930.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11721.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7268.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19860.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18756.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6377.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM NLEX 42CM 10MM ","code_information":[{"code":"350145","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19285.00,"discounted_cash":19285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8678.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10244.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6352.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17356.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16392.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5573.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI 12MM 360MM TI ","code_information":[{"code":"175038","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI 130DD L400MM ","code_information":[{"code":"354668","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21085.00,"discounted_cash":21085.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9488.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11200.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6945.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18976.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16868.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16868.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17922.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16868.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6093.56,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI 200X13 FEM CN ","code_information":[{"code":"351849","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19740.00,"discounted_cash":19740.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8883.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10485.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6502.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17766.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16779.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15792.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5704.86,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI 300MM 12MM TI ","code_information":[{"code":"24926","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L255MM OD8MM ","code_information":[{"code":"351870","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L32CM OD12MM ","code_information":[{"code":"354065","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19285.00,"discounted_cash":19285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8678.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10244.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6352.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17356.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16392.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5573.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L360MM OD9MM ","code_information":[{"code":"385036","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14875.00,"discounted_cash":14875.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6693.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7901.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4899.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13387.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12643.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11900.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4298.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L38CM OD11MM ","code_information":[{"code":"354027","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19285.00,"discounted_cash":19285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8678.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10244.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6352.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17356.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16392.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5573.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L405MM OD8MM ","code_information":[{"code":"351871","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI L40CM OD13MM ","code_information":[{"code":"353199","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19285.00,"discounted_cash":19285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8678.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10244.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6352.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17356.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16392.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15428.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5573.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL IM TI MT-NL 7165503 ","code_information":[{"code":"358945","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22263.00,"discounted_cash":22263.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10018.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11826.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7333.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20036.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18923.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6434.01,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL INTRTN 1.5X38X130 ","code_information":[{"code":"357257","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29874.00,"discounted_cash":29874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13443.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15869.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9840.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26886.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":25392.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23899.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8633.59,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL KN GRY 8.5MMX38CM ","code_information":[{"code":"20890","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16138.00,"discounted_cash":16138.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7262.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8572.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5315.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14524.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13717.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4663.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL KNEE 10MM X 26CM ","code_information":[{"code":"25182","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16880.00,"discounted_cash":16880.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7596.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8966.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5560.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15192.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13504.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13504.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14348.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13504.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4878.32,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL KNEE GREY 8.528 ","code_information":[{"code":"20887","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16138.00,"discounted_cash":16138.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7262.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8572.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5315.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14524.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13717.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4663.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL LNG 125D 10X340MM ","code_information":[{"code":"387222","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26778.00,"discounted_cash":26778.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12050.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14224.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8820.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24100.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22761.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21422.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7738.84,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL LT DPHSL 11.5X36 ","code_information":[{"code":"350301","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31828.00,"discounted_cash":31828.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14322.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16907.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10484.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28645.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27053.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25462.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9198.29,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL META TIB 11.5X35 ","code_information":[{"code":"358955","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22262.00,"discounted_cash":22262.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10017.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11825.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7333.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20035.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17809.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17809.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18922.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17809.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6433.72,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL NTRL LT 9.3MM 34CM ","code_information":[{"code":"356246","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24311.00,"discounted_cash":24311.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10939.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12914.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8008.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21879.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19448.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19448.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20664.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19448.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7025.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL PROXIMAL IM HUM 7.0 ","code_information":[{"code":"171206","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22067.00,"discounted_cash":22067.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9930.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11721.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7268.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19860.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18756.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17653.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6377.36,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL SHORT TFN 11X130 ","code_information":[{"code":"23005","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16018.00,"discounted_cash":16018.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7208.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8508.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5276.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14416.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12814.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12814.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13615.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12814.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4629.20,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TAN LT 11.5MM 36CM ","code_information":[{"code":"381232","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23887.00,"discounted_cash":23887.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10749.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12688.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7868.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21498.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20303.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19109.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6903.34,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 10.5MM 34CM ","code_information":[{"code":"353161","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25283.00,"discounted_cash":25283.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11377.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13430.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8328.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22754.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21490.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7306.79,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 10MM 315MM ","code_information":[{"code":"358149","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13619.00,"discounted_cash":13619.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6128.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7234.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4486.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12257.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11576.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3935.89,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 10MM 390MM ","code_information":[{"code":"380222","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 11MM 315MM ","code_information":[{"code":"358077","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 12MM 255MM ","code_information":[{"code":"380233","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 12MM 360MM ","code_information":[{"code":"435037","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24075.00,"discounted_cash":24075.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10833.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12788.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7930.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21667.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20463.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19260.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6957.68,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 8MM 300MM ","code_information":[{"code":"171780","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 8MM 420MM ","code_information":[{"code":"380204","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 9MM 330MM ","code_information":[{"code":"358188","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13619.00,"discounted_cash":13619.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6128.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7234.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4486.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12257.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11576.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10895.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3935.89,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB 9X360MM ","code_information":[{"code":"353618","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25283.00,"discounted_cash":25283.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11377.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13430.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8328.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22754.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21490.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20226.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7306.79,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB FEM TRGN 10X36 ","code_information":[{"code":"22072","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16138.00,"discounted_cash":16138.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7262.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8572.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5315.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14524.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13717.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12910.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4663.88,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB MT-NL 11.5X34 ","code_information":[{"code":"358954","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22187.00,"discounted_cash":22187.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9984.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11785.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7308.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19968.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18858.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17749.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6412.04,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB MTNL 10MM 28CM ","code_information":[{"code":"354754","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22263.00,"discounted_cash":22263.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10018.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11826.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7333.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20036.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18923.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17810.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6434.01,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIB TI CANN 10X360 ","code_information":[{"code":"26094","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15222.00,"discounted_cash":15222.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6849.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8085.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5014.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13699.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12177.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12177.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12938.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12177.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4399.16,"methodology":"percent of total billed charges"}]}]},{"description":"NAIL TIBIAL 04.004.655S ","code_information":[{"code":"26426","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17290.00,"discounted_cash":17290.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7780.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9184.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5695.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15561.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14696.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13832.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4996.81,"methodology":"percent of total billed charges"}]}]},{"description":"NOVOSEVEN RT 1 MG INJ ","drug_information":{"unit":"1","type":"ME"},"code_information":[{"code":"125344","type":"CDM"},{"code":"J7189","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15196.25,"discounted_cash":15196.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6838.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6686.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13676.63,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12157.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2279.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12157.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12916.81,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12157.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4391.72,"methodology":"percent of total billed charges"}]}]},{"description":"NRSTM CHGR IMPL 2.2INX2. ","code_information":[{"code":"388756","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":37310.00,"discounted_cash":37310.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7088.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7088.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16789.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19819.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12289.91,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":14782.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9178.26,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":9178.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":16416.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33579.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":8320.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29848.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":51114.70,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5596.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5596.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31713.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":25370.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29848.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":11193.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24251.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24251.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24251.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10782.59,"methodology":"percent of total billed charges"}]}]},{"description":"NRSTM IMPL 33CM PSC QD + ","code_information":[{"code":"350742","type":"CDM"},{"code":"C1778","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16988.00,"discounted_cash":16988.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7644.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9024.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5595.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15289.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14439.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13590.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4909.53,"methodology":"percent of total billed charges"}]}]},{"description":"NS 1000 ML ","drug_information":{"unit":"1000","type":"ML"},"code_information":[{"code":"127582","type":"CDM"},{"code":"J7030","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":168.25,"discounted_cash":168.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":75.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":74.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":151.43,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":134.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":25.24,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":134.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":143.01,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":134.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":48.62,"methodology":"percent of total billed charges"}]}]},{"description":"NSP THOR AORT W/ ANGIO ","code_information":[{"code":"466221","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21816.00,"discounted_cash":21816.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9817.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8643.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9599.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19634.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4864.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29887.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18543.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6304.82,"methodology":"percent of total billed charges"}]}]},{"description":"NUT BN ORTH SHRT ","code_information":[{"code":"387837","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1224.00,"discounted_cash":1224.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":232.56,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":122.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":232.56,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":550.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":650.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":403.19,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":484.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":301.10,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":301.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":538.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1101.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":272.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":979.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1676.88,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":183.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":183.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":979.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1040.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":832.32,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":979.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":367.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":353.74,"methodology":"percent of total billed charges"}]}]},{"description":"NUT LCKNG SCREW CAP SPN ","code_information":[{"code":"353333","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2258.00,"discounted_cash":2258.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":225.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":225.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":225.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1016.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1199.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":743.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2032.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1806.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3093.46,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1806.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1919.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1806.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1467.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1467.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1467.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":652.56,"methodology":"percent of total billed charges"}]}]},{"description":"NUT SPNL PASS LP PDCL FX ","code_information":[{"code":"353234","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":949.00,"discounted_cash":949.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":427.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":504.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":312.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":854.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":759.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":759.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":806.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":759.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":274.26,"methodology":"percent of total billed charges"}]}]},{"description":"NYSTATIN POWDER 15GM ","code_information":[{"code":"127284","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":201.25,"discounted_cash":201.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":38.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":20.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":38.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":90.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":106.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":66.29,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":79.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":49.51,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":49.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":88.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":181.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":44.88,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":161.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":275.71,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":30.19,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":30.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":161.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":171.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":136.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":161.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":60.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":130.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":58.16,"methodology":"percent of total billed charges"}]}]},{"description":"O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC ","code_information":[{"code":"940","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":41873.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":25133.51,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":30969.58,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":20517.15,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":26159.37,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":41454.27,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":17952.51,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":41873.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":36161.48,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":25133.51,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":26928.76,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":25646.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":41873.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":41873.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":25646.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":17952.51,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":17952.51,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":17952.51,"methodology":"fee schedule"}]}]},{"description":"OB ANES MIN TO 1 HOUR ","code_information":[{"code":"70350","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1724.75,"discounted_cash":1724.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":327.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":172.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":172.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":172.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":327.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":776.14,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":916.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":568.13,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":683.35,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":424.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":424.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":758.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1552.28,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":384.62,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1379.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2362.91,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":258.71,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":258.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1379.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1466.04,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1172.83,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1379.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":517.42,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1121.09,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1121.09,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1121.09,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":498.45,"methodology":"percent of total billed charges"}]}]},{"description":"OB SURG MAJOR TO 1 HR ","code_information":[{"code":"70250","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":42243.75,"discounted_cash":42243.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4224.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4224.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4224.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19009.69,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":16736.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10391.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10391.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":18587.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":38019.38,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":9420.36,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33795.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":57873.94,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6336.56,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6336.56,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33795.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35907.19,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27458.44,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27458.44,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27458.44,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12208.44,"methodology":"percent of total billed charges"}]}]},{"description":"OBS PER HOUR ","code_information":[{"code":"961489","type":"CDM"},{"code":"G0378","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":512.75,"discounted_cash":512.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":230.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":461.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":435.84,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":348.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":148.18,"methodology":"percent of total billed charges"}]}]},{"description":"OBS PER HOUR ","code_information":[{"code":"961498","type":"CDM"},{"code":"G0378","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":512.75,"discounted_cash":512.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":230.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":461.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":435.84,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":348.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":148.18,"methodology":"percent of total billed charges"}]}]},{"description":"OBS PER HOUR ","code_information":[{"code":"961509","type":"CDM"},{"code":"G0378","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":512.75,"discounted_cash":512.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":230.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":126.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":461.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":410.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":435.84,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":348.67,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":148.18,"methodology":"percent of total billed charges"}]}]},{"description":"OBTURATOR BLDLSS 8MM ","code_information":[{"code":"384547","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1756.00,"discounted_cash":1756.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":333.64,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":333.64,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":790.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":932.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":578.43,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":695.73,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":431.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":431.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":772.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1580.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":391.59,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1404.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2405.72,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":263.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":263.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1404.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1492.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1194.08,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1404.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":526.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1141.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1141.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1141.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":507.48,"methodology":"percent of total billed charges"}]}]},{"description":"OCCLUDE ART BLN HD/NCK ","code_information":[{"code":"271623","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":83107.50,"discounted_cash":83107.50,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8310.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8310.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8310.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":37398.38,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":32927.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":20444.45,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":20444.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":36567.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":74796.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":18532.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":66486.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":113857.27,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":12466.13,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":12466.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":66486.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":70641.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":54019.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":54019.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":54019.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24018.07,"methodology":"percent of total billed charges"}]}]},{"description":"OCCLUDER CV 35X18MM ","code_information":[{"code":"386272","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":143219.00,"discounted_cash":143219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":14321.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":14321.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":14321.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":64448.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":76077.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":47176.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":128897.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":114575.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":196210.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":114575.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":121736.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":114575.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":93092.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":93092.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":93092.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":41390.29,"methodology":"percent of total billed charges"}]}]},{"description":"OCCULT BLD SCN 3 SPEC ","code_information":[{"code":"365300","type":"CDM"},{"code":"82270","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":243.50,"discounted_cash":243.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":46.27,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":46.27,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":109.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":107.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":219.15,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":54.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":194.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":36.52,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":194.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":206.97,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":165.58,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":194.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":70.37,"methodology":"percent of total billed charges"}]}]},{"description":"OLANZAPINE 10 MG INJ ","drug_information":{"unit":"10","type":"ME"},"code_information":[{"code":"128461","type":"CDM"},{"code":"J2359","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":321.25,"discounted_cash":321.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":144.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":141.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":289.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":48.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":273.06,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":257.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":92.84,"methodology":"percent of total billed charges"}]}]},{"description":"OLUMIANT 2 MG PO ","code_information":[{"code":"216436","type":"CDM"},{"code":"C9399","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":441.75,"discounted_cash":441.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":198.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":194.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":397.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":66.26,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":375.49,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":353.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":127.67,"methodology":"percent of total billed charges"}]}]},{"description":"ONABOTULINUMTOXA 1U INJ ","drug_information":{"unit":"1","type":"UN"},"code_information":[{"code":"126975","type":"CDM"},{"code":"J0585","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":87.50,"discounted_cash":87.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":38.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":78.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":13.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":74.38,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":25.29,"methodology":"percent of total billed charges"}]}]},{"description":"ONDANSETRON HCL 4MGTAB ","code_information":[{"code":"125131","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":229.50,"discounted_cash":229.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":43.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":22.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":43.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":103.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":121.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":75.60,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":90.93,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":56.46,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":56.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":100.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":206.55,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":51.18,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":183.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":314.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":34.42,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":34.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":183.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":195.07,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":156.06,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":183.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":68.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":149.18,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":149.18,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":149.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":66.33,"methodology":"percent of total billed charges"}]}]},{"description":"OP VISIT LEVEL 4 EST ","code_information":[{"code":"22417","type":"CDM"},{"code":"99214","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":717.75,"discounted_cash":717.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":136.37,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":136.37,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":322.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":315.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":645.98,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":160.06,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":574.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":107.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":574.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":610.09,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":488.07,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":574.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":215.32,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":207.43,"methodology":"percent of total billed charges"}]}]},{"description":"ORBITAL PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"114","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":23806.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":14454.49,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":18312.16,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":11799.58,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":15044.47,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":23567.94,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":10324.64,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":23806.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":20796.77,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":14454.49,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":15486.95,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":14749.48,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":23806.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":23806.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":14749.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":10324.64,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":10324.64,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":10324.64,"methodology":"fee schedule"}]}]},{"description":"ORTH MGT TRAIN EA 15M SP ","code_information":[{"code":"20780","type":"CDM"},{"code":"97760","type":"CPT"}],"standard_charges":[{"modifiers":"GN","modifiers_description":"Services delivered under an outpatient speech language pathology plan of care","setting":"outpatient","gross_charge":679.25,"discounted_cash":679.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.06,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":129.06,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":305.66,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":269.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":298.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":611.33,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":151.47,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":543.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":101.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":543.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":577.36,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":461.89,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":543.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":196.30,"methodology":"percent of total billed charges"}]}]},{"description":"ORTHOSIS KNEE/ANKL/FOO ","code_information":[{"code":"181076","type":"CDM"},{"code":"L2134","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10619.00,"discounted_cash":10619.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2017.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2017.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4778.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5640.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3497.90,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4207.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2612.27,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2612.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4672.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9557.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2368.04,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8495.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1592.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8495.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9026.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7220.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8495.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3185.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3068.89,"methodology":"percent of total billed charges"}]}]},{"description":"OSMOLAL FECES ","code_information":[{"code":"372061","type":"CDM"},{"code":"84999","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4.89,"discounted_cash":4.89,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.93,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":0.93,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1.61,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.09,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.91,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.91,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4.16,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3.33,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3.91,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.41,"methodology":"percent of total billed charges"}]}]},{"description":"OSTEOMYELITIS WITH CC ","code_information":[{"code":"540","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":25090.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":15745.12,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":20716.09,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":12853.16,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":16387.78,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":24839.10,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":11246.51,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":25090.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":22653.69,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":15745.12,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":16869.77,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":16066.45,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":25090.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":25090.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":16066.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":11246.51,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":11246.51,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":11246.51,"methodology":"fee schedule"}]}]},{"description":"OSTEOTOME LNG 6.0MM ","code_information":[{"code":"385560","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":19722.00,"discounted_cash":19722.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3747.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1972.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1972.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1972.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3747.18,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8874.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10476.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6496.43,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":7813.86,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4851.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":4851.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":8677.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17749.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4398.01,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15777.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":27019.14,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2958.30,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2958.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15777.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16763.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13410.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15777.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":5916.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12819.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12819.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":12819.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5699.66,"methodology":"percent of total billed charges"}]}]},{"description":"OTHBLND SM DFCT 5CC ","code_information":[{"code":"174757","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10378.00,"discounted_cash":10378.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1037.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1037.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1037.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4670.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5512.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3418.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9340.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8302.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14217.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8302.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8821.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8302.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6745.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6745.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6745.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2999.24,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC ","code_information":[{"code":"229","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":133992.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":115539.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":115539.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Aetna Senior Health Plan","plan_name":"MCR","standard_charge_dollar":2800.00,"methodology":"case rate"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem","plan_name":"COMM","standard_charge_dollar":133992.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. "},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":36566.45,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":46397.45,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":29850.16,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":38058.95,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_dollar":51650.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_dollar":51650.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":60837.48,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":26118.89,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_dollar":60741.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":61452.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":52610.91,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":36566.45,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":39178.33,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":37312.70,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_dollar":48500.00,"methodology":"case rate"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":61452.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":61452.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_dollar":41522.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 6. "},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":37312.70,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":88806.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 10. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":26118.89,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":26118.89,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":26118.89,"methodology":"fee schedule"}]}]},{"description":"OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC ","code_information":[{"code":"357","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":42457.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":26749.38,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":31572.59,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":21836.23,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":27841.20,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":42032.43,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":19106.70,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":42457.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":38486.36,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":26749.38,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":28660.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":27295.29,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":42457.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":42457.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":27295.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":19106.70,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":19106.70,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":19106.70,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC ","code_information":[{"code":"155","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":18294.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":11598.55,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":14142.51,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":9468.21,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":12071.97,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":18111.06,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":8284.68,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":18294.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":16687.72,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":11598.55,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":12427.02,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11835.26,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":18294.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":18294.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11835.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":8284.68,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":8284.68,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":8284.68,"methodology":"fee schedule"}]}]},{"description":"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"630","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":26986.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16972.54,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":19737.44,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":13855.14,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":17665.30,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":26716.14,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":12123.24,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":26986.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":24419.68,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":16972.54,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":18184.87,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":17318.92,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":26986.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":26986.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":17318.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":12123.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":12123.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":12123.24,"methodology":"fee schedule"}]}]},{"description":"OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC ","code_information":[{"code":"423","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":75585.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":47610.93,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":55266.79,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":38866.06,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":49554.23,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":74829.15,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":34007.81,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":75585.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":68501.44,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":47610.93,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":51011.71,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":48582.58,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":75585.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":75585.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":48582.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":34007.81,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":34007.81,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":34007.81,"methodology":"fee schedule"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC ","code_information":[{"code":"698","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":31974.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":20187.05,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":24652.86,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":16479.22,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":21011.01,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":31654.26,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":14419.32,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":31974.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":29044.63,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":20187.05,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":21628.98,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":20599.03,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":31974.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":31974.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":20599.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":14419.32,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":14419.32,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":14419.32,"methodology":"fee schedule"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC ","code_information":[{"code":"729","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":19452.44,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":13520.14,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":16580.88,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":11036.85,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":14071.98,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":19207.98,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":9657.24,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":19402.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":19452.44,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":13520.14,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":14485.86,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":13796.06,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":19402.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":19402.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":13796.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":9657.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":9657.24,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":9657.24,"methodology":"fee schedule"}]}]},{"description":"OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC ","code_information":[{"code":"963","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":56431.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":32090.04,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":42662.91,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":26195.95,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":33399.84,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":52316.55,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":22921.46,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":52845.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":46170.37,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":32090.04,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":34382.19,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":32744.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":52845.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":52845.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":32744.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":56431.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":22921.46,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":22921.46,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":22921.46,"methodology":"fee schedule"}]}]},{"description":"OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ","code_information":[{"code":"843","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":40274.67,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":22625.80,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":40274.67,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":18470.04,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":23549.30,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":35599.41,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":16161.28,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":35959.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":32553.45,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":22625.80,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":24241.93,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":23087.55,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":35959.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":35959.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":23087.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":16161.28,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":16161.28,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":16161.28,"methodology":"fee schedule"}]}]},{"description":"OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC ","code_information":[{"code":"959","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":144113.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":31252.22,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":36105.65,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":25512.02,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":32527.82,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":48453.57,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":22323.01,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":48943.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":44964.93,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":31252.22,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":33484.52,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":31890.02,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":48943.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":48943.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":31890.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":144113.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 8. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":22323.01,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":22323.01,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":22323.01,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ","code_information":[{"code":"168","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":26201.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":16427.79,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":19925.79,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":13410.44,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":17098.31,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":25938.99,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":11734.13,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":26201.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":23635.90,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":16427.79,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":17601.20,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":16763.05,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 1. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":26201.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":26201.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":16763.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":11734.13,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":11734.13,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":11734.13,"methodology":"fee schedule"}]}]},{"description":"OTITIS MEDIA AND URI WITH MCC ","code_information":[{"code":"152","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":22964.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":13909.74,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":18425.42,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":11354.89,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":14477.48,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":22734.36,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":9935.53,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":22964.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":20012.99,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":13909.74,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":14903.29,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":14193.61,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":22964.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":22964.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":14193.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":9935.53,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":9935.53,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":9935.53,"methodology":"fee schedule"}]}]},{"description":"OXALIPLATIN 200 MG INJ ","drug_information":{"unit":"200","type":"ME"},"code_information":[{"code":"126308","type":"CDM"},{"code":"J9263","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":39098.50,"discounted_cash":39098.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17594.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":17203.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":35188.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31278.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5864.77,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31278.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33233.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31278.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11299.47,"methodology":"percent of total billed charges"}]}]},{"description":"OXYBUTYNIN 5MG TAB ","code_information":[{"code":"120537","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":11.00,"discounted_cash":11.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.09,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.09,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3.62,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.45,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":15.07,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3.18,"methodology":"percent of total billed charges"}]}]},{"description":"OXYCODONE IR 20 MG TAB ","code_information":[{"code":"126400","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21.25,"discounted_cash":21.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8.42,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4.74,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29.11,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6.14,"methodology":"percent of total billed charges"}]}]},{"description":"OXYTOCIN 10 U INJ ","drug_information":{"unit":"10","type":"UN"},"code_information":[{"code":"125795","type":"CDM"},{"code":"J2590","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28.00,"discounted_cash":28.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8.09,"methodology":"percent of total billed charges"}]}]},{"description":"PACEMAKER VALITUDE U128 ","code_information":[{"code":"358725","type":"CDM"},{"code":"C2621","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":65254.00,"discounted_cash":65254.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":29364.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":34662.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":21494.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":58728.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52203.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52203.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":55465.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":52203.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":18858.41,"methodology":"percent of total billed charges"}]}]},{"description":"PACEMKR ADPTA 2CH ADDR03 ","code_information":[{"code":"358613","type":"CDM"},{"code":"C1785","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31307.00,"discounted_cash":31307.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14088.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16630.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10312.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28176.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26610.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25045.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9047.72,"methodology":"percent of total billed charges"}]}]},{"description":"PACEMKR ALTR 49X54 S205 ","code_information":[{"code":"357875","type":"CDM"},{"code":"C1785","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36471.00,"discounted_cash":36471.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16411.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19373.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12013.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32823.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29176.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29176.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31000.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29176.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10540.12,"methodology":"percent of total billed charges"}]}]},{"description":"PACEMKR ZPHR SR 5620 ","code_information":[{"code":"467125","type":"CDM"},{"code":"C1786","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":37050.00,"discounted_cash":37050.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16672.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19680.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12204.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33345.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31492.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10707.45,"methodology":"percent of total billed charges"}]}]},{"description":"PACK INSTRUMENT ORTHO ST ","code_information":[{"code":"389535","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14485.01,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"PACKING COIL LP 15CM ","code_information":[{"code":"391044","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14477.00,"discounted_cash":14477.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1447.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1447.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1447.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6514.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7690.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4768.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13029.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11581.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":19833.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11581.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12305.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11581.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9410.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9410.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9410.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4183.85,"methodology":"percent of total billed charges"}]}]},{"description":"PACKING SINUS ANT 8CM ","code_information":[{"code":"384734","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1751.00,"discounted_cash":1751.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":332.69,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":175.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":332.69,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":787.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":930.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":576.78,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":693.75,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":430.75,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":430.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":770.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1575.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":390.47,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1400.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2398.87,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":262.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":262.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1400.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1488.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1190.68,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1400.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":525.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1138.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1138.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1138.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":506.04,"methodology":"percent of total billed charges"}]}]},{"description":"PACU 00-02 HR ","code_information":[{"code":"70345","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5524.50,"discounted_cash":5524.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1049.65,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":552.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":552.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":552.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1049.65,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2486.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2934.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1819.77,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2188.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1359.03,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1359.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2430.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4972.05,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1231.96,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4419.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":7568.56,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":828.67,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":828.67,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4419.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4695.82,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3756.66,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4419.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1657.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3590.93,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3590.93,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3590.93,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1596.58,"methodology":"percent of total billed charges"}]}]},{"description":"PAD HMSTC 2.4CM X 1.2CM ","code_information":[{"code":"390578","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1173.00,"discounted_cash":1173.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":222.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":117.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":117.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":117.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":222.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":527.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":623.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":386.39,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":464.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":288.56,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":288.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":516.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1055.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":261.58,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":938.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1607.01,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":175.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":175.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":938.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":997.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":797.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":938.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":351.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":762.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":762.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":762.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":339.00,"methodology":"percent of total billed charges"}]}]},{"description":"PAMIDRONATE 90 MG INJ ","drug_information":{"unit":"90","type":"ME"},"code_information":[{"code":"125670","type":"CDM"},{"code":"J2430","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2057.25,"discounted_cash":2057.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":925.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":905.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1851.53,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1645.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":308.59,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1645.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1748.66,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1645.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":594.55,"methodology":"percent of total billed charges"}]}]},{"description":"PANITUMUMAB 100 MG INJ ","drug_information":{"unit":"100","type":"ME"},"code_information":[{"code":"125691","type":"CDM"},{"code":"J9303","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8979.75,"discounted_cash":8979.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4040.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3951.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8081.77,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7183.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1346.96,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7183.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7632.79,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7183.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2595.15,"methodology":"percent of total billed charges"}]}]},{"description":"PAPDX TCSC NRSC BETH ","code_information":[{"code":"320182","type":"CDM"},{"code":"88164","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":313.25,"discounted_cash":313.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":59.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":59.52,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":140.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":137.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":281.93,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":69.85,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":250.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":46.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":250.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":266.26,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":213.01,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":250.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":93.97,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":90.53,"methodology":"percent of total billed charges"}]}]},{"description":"PARAINFLUENZA 1 AB QL ","code_information":[{"code":"371290","type":"CDM"},{"code":"86790","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":10.02,"discounted_cash":10.02,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9.02,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.02,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.02,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8.52,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6.81,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8.02,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.90,"methodology":"percent of total billed charges"}]}]},{"description":"PAROXETINE 10MG TAB ","code_information":[{"code":"120989","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":41.50,"discounted_cash":41.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":22.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":13.67,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":16.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":18.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":37.35,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":9.25,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":56.85,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.22,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35.27,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":28.22,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":33.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":12.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26.98,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26.98,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26.98,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11.99,"methodology":"percent of total billed charges"}]}]},{"description":"PARTICLES EMBL 100-300UM ","code_information":[{"code":"355767","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":712.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9766.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4633.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PASSER ACPS SHTL SUTURE ","code_information":[{"code":"355383","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4566.00,"discounted_cash":4566.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":867.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":456.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":456.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":456.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":867.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2054.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2425.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1504.04,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1809.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1123.24,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1123.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2009.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4109.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1018.22,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3652.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":6255.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":684.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":684.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3652.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3881.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3104.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3652.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1369.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2967.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2967.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2967.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1319.57,"methodology":"percent of total billed charges"}]}]},{"description":"PASSER SURG SHRT 36CM ","code_information":[{"code":"386319","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"PASSER SUT PRLD NDL ","code_information":[{"code":"385921","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27318.00,"discounted_cash":27318.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2731.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5190.42,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12293.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14511.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8998.55,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10823.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6720.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12019.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24586.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6091.91,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":37425.66,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4097.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23220.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18576.24,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21854.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8195.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17756.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7894.90,"methodology":"percent of total billed charges"}]}]},{"description":"PASSY MUIR VALVE ","code_information":[{"code":"598001","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":348.00,"discounted_cash":348.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":66.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":34.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":34.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":34.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":66.12,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":156.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":184.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":114.63,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":137.88,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":85.61,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":85.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":153.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":313.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":77.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":278.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":476.76,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":52.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":52.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":278.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":295.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":236.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":278.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":104.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":226.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":226.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":226.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":100.57,"methodology":"percent of total billed charges"}]}]},{"description":"PATCH CV CLOSURE 7X15CM ","code_information":[{"code":"383612","type":"CDM"},{"code":"C1768","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16396.00,"discounted_cash":16396.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7378.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8709.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5400.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14756.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13116.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13116.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13936.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13116.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4738.44,"methodology":"percent of total billed charges"}]}]},{"description":"PATCH DURA 2X2IN ","code_information":[{"code":"386874","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8123.00,"discounted_cash":8123.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":812.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":812.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":812.30,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3655.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4314.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2675.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7310.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6498.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11128.51,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6498.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6904.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6498.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5279.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5279.95,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5279.95,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2347.55,"methodology":"percent of total billed charges"}]}]},{"description":"PATCH DURA CLGN 2X2IN ","code_information":[{"code":"171556","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5659.00,"discounted_cash":5659.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":565.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":565.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":565.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2546.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3006.06,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1864.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5093.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4527.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":7752.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4527.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4810.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4527.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3678.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3678.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3678.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1635.45,"methodology":"percent of total billed charges"}]}]},{"description":"PATCH SFT TIS 1X5X10 ","code_information":[{"code":"743191","type":"CDM"},{"code":"C1781","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5844.00,"discounted_cash":5844.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2629.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3104.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1925.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5259.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4675.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4675.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4967.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4675.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1688.92,"methodology":"percent of total billed charges"}]}]},{"description":"PATELLA CNTLZR SET 12X14 ","code_information":[{"code":"385550","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3610.00,"discounted_cash":3610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1624.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1917.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1189.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3249.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2888.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2888.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3068.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2888.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1043.29,"methodology":"percent of total billed charges"}]}]},{"description":"PATELLAR LRG IMPLNT STRL ","code_information":[{"code":"171351","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4670.00,"discounted_cash":4670.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2101.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2480.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1538.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4203.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3736.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3736.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3969.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3736.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1349.63,"methodology":"percent of total billed charges"}]}]},{"description":"PATH DECALCIFICATION ","code_information":[{"code":"320060","type":"CDM"},{"code":"88311","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":55.75,"discounted_cash":55.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":10.59,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":10.59,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":25.09,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":22.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":24.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":50.17,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":12.43,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":44.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":8.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":44.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":37.91,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":44.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":16.11,"methodology":"percent of total billed charges"}]}]},{"description":"PCA-1/ANTI-YO AB IB CSF ","code_information":[{"code":"378973","type":"CDM"},{"code":"84182","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":51.48,"discounted_cash":51.48,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.78,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.78,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":22.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":46.33,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":11.48,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.18,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":43.76,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":35.01,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":41.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14.88,"methodology":"percent of total billed charges"}]}]},{"description":"PCMKR CRD 4.45X4.81X0.75 ","code_information":[{"code":"382208","type":"CDM"},{"code":"C1786","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31493.00,"discounted_cash":31493.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14171.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16729.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10373.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28343.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25194.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25194.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26769.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25194.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9101.48,"methodology":"percent of total billed charges"}]}]},{"description":"PCMKR DUAL CHMBR MRI ","code_information":[{"code":"358604","type":"CDM"},{"code":"C1785","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":47134.00,"discounted_cash":47134.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21210.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":25037.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15525.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":42420.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37707.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37707.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":40063.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37707.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13621.73,"methodology":"percent of total billed charges"}]}]},{"description":"PCMKR NSIG ULT SSIR1190 ","code_information":[{"code":"23222","type":"CDM"},{"code":"C1786","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":46891.00,"discounted_cash":46891.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21100.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24908.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15445.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":42201.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":39857.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37512.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13551.50,"methodology":"percent of total billed charges"}]}]},{"description":"PCMKR ZPHR XL SR 5626 ","code_information":[{"code":"173149","type":"CDM"},{"code":"C1786","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":37050.00,"discounted_cash":37050.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16672.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19680.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12204.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33345.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31492.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29640.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10707.45,"methodology":"percent of total billed charges"}]}]},{"description":"PCNG K 600000 U INJ ","drug_information":{"unit":"600000","type":"UN"},"code_information":[{"code":"126720","type":"CDM"},{"code":"J2540","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24.75,"discounted_cash":24.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":10.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22.27,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.71,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.15,"methodology":"percent of total billed charges"}]}]},{"description":"PEG BN 2.7MM 20MM ","code_information":[{"code":"438905","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"PEG BN THRD LCK 2.3X22MM ","code_information":[{"code":"385715","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2395.00,"discounted_cash":2395.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1077.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1272.22,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":788.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2155.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1916.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1916.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2035.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1916.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":692.15,"methodology":"percent of total billed charges"}]}]},{"description":"PEG FX CORT LCK 2.3X14MM ","code_information":[{"code":"356513","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2538.00,"discounted_cash":2538.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1142.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1348.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":836.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2284.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2157.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":733.48,"methodology":"percent of total billed charges"}]}]},{"description":"PEG LCK 2.0X16 53-20616 ","code_information":[{"code":"358407","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3493.00,"discounted_cash":3493.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1571.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1855.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1150.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3143.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2969.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1009.48,"methodology":"percent of total billed charges"}]}]},{"description":"PEG STNDRD 4.0X50 ","code_information":[{"code":"25507","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2794.00,"discounted_cash":2794.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1257.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1484.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":920.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2514.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2235.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2235.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2374.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2235.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":807.47,"methodology":"percent of total billed charges"}]}]},{"description":"PEG THRD N-LCK 2.7X18MM ","code_information":[{"code":"430824","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"PEMBROLIZUMAB 100 MG INJ ","drug_information":{"unit":"100","type":"ME"},"code_information":[{"code":"127714","type":"CDM"},{"code":"J9271","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31001.50,"discounted_cash":31001.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13950.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":13640.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":27901.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24801.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4650.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24801.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":26351.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":24801.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8959.43,"methodology":"percent of total billed charges"}]}]},{"description":"PEN G BEN 100000 U INJJW ","drug_information":{"unit":"100000","type":"UN"},"code_information":[{"code":"128262","type":"CDM"},{"code":"J0561","type":"HCPCS"}],"standard_charges":[{"modifiers":"JW","modifiers_description":"Drug amount discarded/not administered to any patient","setting":"outpatient","gross_charge":525.75,"discounted_cash":525.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":236.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":231.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":473.18,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":420.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":78.86,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":420.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":446.89,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":420.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":151.94,"methodology":"percent of total billed charges"}]}]},{"description":"PENICILLIN VK 250MG TAB ","code_information":[{"code":"120486","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8.75,"discounted_cash":8.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":0.88,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.66,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2.88,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3.47,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7.88,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.95,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":11.99,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1.31,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7.44,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2.63,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5.69,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2.53,"methodology":"percent of total billed charges"}]}]},{"description":"PENTOBARBITAL 50 MG INJ ","drug_information":{"unit":"50","type":"ME"},"code_information":[{"code":"125861","type":"CDM"},{"code":"J2515","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":593.50,"discounted_cash":593.50,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":267.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":261.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":534.15,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":474.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":89.03,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":474.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":504.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":474.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":171.52,"methodology":"percent of total billed charges"}]}]},{"description":"PERAMIVIR 200 MG INJ ","drug_information":{"unit":"200","type":"ME"},"code_information":[{"code":"127632","type":"CDM"},{"code":"J2547","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1573.75,"discounted_cash":1573.75,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":708.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":692.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1416.38,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1259.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":236.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1259.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1337.69,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1259.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":454.81,"methodology":"percent of total billed charges"}]}]},{"description":"PERC PLEUR DRN W/O IMG ","code_information":[{"code":"262556","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":5377.75,"discounted_cash":5377.75,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":537.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":537.77,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":537.77,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2419.99,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2130.66,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1322.93,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1322.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2366.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4839.98,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1199.24,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4302.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":7367.52,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":806.66,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":806.66,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4302.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4571.09,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3495.54,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3495.54,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3495.54,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1554.17,"methodology":"percent of total billed charges"}]}]},{"description":"PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC ","code_information":[{"code":"273","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":98084.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_dollar":98084.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_dollar":98084.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem","plan_name":"COMM","standard_charge_dollar":32876.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Anthem ","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":45805.43,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":56406.73,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":37392.18,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":47675.03,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":74563.83,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":32718.16,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":75317.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":65903.72,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":45805.43,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":49077.24,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":46740.23,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":75317.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":75317.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":46740.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":68775.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":32718.16,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":32718.16,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":32718.16,"methodology":"fee schedule"}]}]},{"description":"PERFORATOR CRNL 14MM ","code_information":[{"code":"426689","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":11704.00,"discounted_cash":11704.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2223.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1170.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1170.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1170.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2223.76,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5266.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6217.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3855.30,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4637.12,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2879.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2879.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5149.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10533.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2609.99,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":16034.48,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1755.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1755.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9948.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7958.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9363.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3511.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7607.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7607.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7607.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3382.46,"methodology":"percent of total billed charges"}]}]},{"description":"PERITONEAL ADHESIOLYSIS WITH CC ","code_information":[{"code":"336","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":40689.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":25146.15,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":29897.11,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":20527.47,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":26172.53,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":40282.11,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":17961.54,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":40689.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":36179.67,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":25146.15,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":26942.31,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":25659.34,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 5. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":40689.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":40689.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":25659.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":17961.54,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":17961.54,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":17961.54,"methodology":"fee schedule"}]}]},{"description":"PERMETHRIN 1% LOT 60ML ","code_information":[{"code":"126685","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":34.75,"discounted_cash":34.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3.48,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":6.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":15.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11.45,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":13.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.55,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":8.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":15.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":31.27,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":7.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":47.61,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.21,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":5.21,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":29.54,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":23.63,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":10.43,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":22.59,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":22.59,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":22.59,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10.04,"methodology":"percent of total billed charges"}]}]},{"description":"PH BLOOD ONLY ","code_information":[{"code":"540555","type":"CDM"},{"code":"82800","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":639.25,"discounted_cash":639.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":121.46,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":121.46,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":287.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":281.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":575.33,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":142.55,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":511.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":95.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":511.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":543.36,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":434.69,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":511.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":184.74,"methodology":"percent of total billed charges"}]}]},{"description":"PHENOBARBITAL LUMINAL QN ","code_information":[{"code":"363850","type":"CDM"},{"code":"80184","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":1191.25,"discounted_cash":1191.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":226.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":226.34,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":536.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":524.15,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1072.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":265.65,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":953.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":178.69,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":953.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1012.56,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":810.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":953.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":344.27,"methodology":"percent of total billed charges"}]}]},{"description":"PHENYLEPH 0.25% NAS SPRY ","code_information":[{"code":"127390","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14.50,"discounted_cash":14.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1.45,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4.78,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":5.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13.05,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":19.86,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2.17,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12.32,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":9.86,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.43,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.43,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9.43,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4.19,"methodology":"percent of total billed charges"}]}]},{"description":"PHENYTOIN 50 MG INJ ","drug_information":{"unit":"50","type":"ME"},"code_information":[{"code":"124249","type":"CDM"},{"code":"J1165","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":46.25,"discounted_cash":46.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":20.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41.63,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.94,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":39.31,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13.37,"methodology":"percent of total billed charges"}]}]},{"description":"PHOSPHORUS BLD ","code_information":[{"code":"363870","type":"CDM"},{"code":"84100","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":328.50,"discounted_cash":328.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":62.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":62.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":147.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":144.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":295.65,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":73.26,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":49.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":279.23,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":223.38,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":94.94,"methodology":"percent of total billed charges"}]}]},{"description":"PILLOW ABDCT XL 19X7IN ","code_information":[{"code":"360451","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3302.00,"discounted_cash":3302.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":627.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":330.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":330.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":330.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":627.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1485.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1754.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1087.68,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1308.25,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":812.29,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":812.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1452.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2971.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":736.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2641.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4523.74,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":495.30,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":495.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2641.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2806.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2245.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2641.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":990.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2146.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2146.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2146.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":954.28,"methodology":"percent of total billed charges"}]}]},{"description":"PIN ADLT SKULL 0.37IN ","code_information":[{"code":"743765","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3216.00,"discounted_cash":3216.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":611.04,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":321.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":321.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":321.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":611.04,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1447.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1708.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1059.35,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1274.18,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":791.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":791.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1415.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2894.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":717.17,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2572.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4405.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":482.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":482.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2572.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2733.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2186.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2572.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":964.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2090.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2090.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2090.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":929.42,"methodology":"percent of total billed charges"}]}]},{"description":"PIN BN STRL 6X200MM ","code_information":[{"code":"391129","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3759.00,"discounted_cash":3759.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1691.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1996.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1238.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3383.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3007.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3195.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3007.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1086.35,"methodology":"percent of total billed charges"}]}]},{"description":"PIN DRILL 1.5MM 100MM ","code_information":[{"code":"359268","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 6H LCK OLECRON ","code_information":[{"code":"173152","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11285.00,"discounted_cash":11285.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5078.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5994.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3717.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10156.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9028.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9028.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9592.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9028.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3261.36,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 7-HOLE 1.5 ","code_information":[{"code":"353377","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11803.00,"discounted_cash":11803.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5311.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6269.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3887.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10622.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9442.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9442.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10032.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9442.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3411.07,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 84MM L4 TRANSLATIO ","code_information":[{"code":"353347","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22586.00,"discounted_cash":22586.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10163.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11997.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7439.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20327.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19198.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6527.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 9 HL LCK STR BN OR ","code_information":[{"code":"352096","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13665.00,"discounted_cash":13665.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6149.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7258.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4501.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12298.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10932.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10932.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11615.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10932.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3949.18,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 93MM 3.5MM 6HL ","code_information":[{"code":"354736","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17078.00,"discounted_cash":17078.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7685.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9071.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5625.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15370.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13662.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13662.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14516.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13662.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4935.54,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE 98 SS 3.5SCR 7HL ","code_information":[{"code":"354160","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21715.00,"discounted_cash":21715.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9771.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11535.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7152.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19543.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18457.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17372.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6275.64,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ANK FX ","code_information":[{"code":"383312","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13443.00,"discounted_cash":13443.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6049.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7140.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4428.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12098.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10754.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10754.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11426.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10754.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3885.03,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ANT CERV 45MM ","code_information":[{"code":"175053","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20622.00,"discounted_cash":20622.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9279.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10954.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6792.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18559.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17528.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5959.76,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ANT CSPN 16MM 1LVL ","code_information":[{"code":"25319","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19640.00,"discounted_cash":19640.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8838.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10432.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6469.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16694.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5675.96,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ANT CSPN 40MM 2LVL ","code_information":[{"code":"351008","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20622.00,"discounted_cash":20622.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9279.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10954.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6792.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18559.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17528.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5959.76,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ANTAL LAT 7HL ","code_information":[{"code":"351876","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23621.00,"discounted_cash":23621.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10629.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12547.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7780.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21258.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18896.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18896.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20077.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18896.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6826.47,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE AO 450.240 CERVIAL ","code_information":[{"code":"741559","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19228.00,"discounted_cash":19228.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8652.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10213.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6333.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17305.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15382.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15382.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16343.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15382.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5556.89,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE AO 450.363 CERVICA ","code_information":[{"code":"746614","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18136.00,"discounted_cash":18136.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8161.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9633.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5974.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16322.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14508.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14508.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15415.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14508.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5241.30,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE AO 450.480 CERVICA ","code_information":[{"code":"20395","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21762.00,"discounted_cash":21762.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9792.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11559.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7168.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19585.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17409.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17409.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18497.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17409.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6289.22,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE ASSEMBLY 34MM 2LV ","code_information":[{"code":"388997","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18658.00,"discounted_cash":18658.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8396.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9911.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6145.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15859.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5392.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN .5 2X3 ","code_information":[{"code":"390950","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 0D MED ","code_information":[{"code":"386263","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26974.00,"discounted_cash":26974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12138.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14328.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8885.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24276.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22927.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21579.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7795.49,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 1/3 3HL 35MM ","code_information":[{"code":"383767","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6671.00,"discounted_cash":6671.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3001.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3543.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2197.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6003.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5336.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5336.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5670.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5336.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1927.92,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 102MM 4HL ","code_information":[{"code":"383774","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21493.00,"discounted_cash":21493.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9671.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11417.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7079.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19343.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17194.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17194.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18269.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17194.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6211.48,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 10H 2.7MM 79MM ","code_information":[{"code":"389450","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9159.00,"discounted_cash":9159.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4121.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4865.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3016.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8243.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7327.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7327.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7785.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7327.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2646.95,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 10HL ","code_information":[{"code":"383772","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12214.00,"discounted_cash":12214.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5496.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6488.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4023.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10992.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10381.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3529.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 10HL 178MM ","code_information":[{"code":"383836","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23211.00,"discounted_cash":23211.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10444.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12329.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7645.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20889.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18568.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18568.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19729.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18568.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6707.98,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 10HL 3.5X116MM ","code_information":[{"code":"919310","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 10HL 62MM ","code_information":[{"code":"409101","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7874.00,"discounted_cash":7874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3543.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4182.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2593.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7086.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6299.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6299.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6692.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6299.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2275.59,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 113MX9X1.5MM ","code_information":[{"code":"389573","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26590.00,"discounted_cash":26590.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11965.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14124.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8758.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23931.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21272.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21272.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22601.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21272.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7684.51,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 11H 43MM 2.7MM ","code_information":[{"code":"383963","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18096.00,"discounted_cash":18096.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8143.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9612.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5960.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16286.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14476.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14476.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15381.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14476.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5229.74,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 12H 150MM ","code_information":[{"code":"915957","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7977.00,"discounted_cash":7977.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3589.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4237.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2627.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7179.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6381.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6381.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6780.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6381.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2305.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 12H 2MM 81MM ","code_information":[{"code":"380678","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 12HL 2.3MM RT ","code_information":[{"code":"354794","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18214.00,"discounted_cash":18214.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8196.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9675.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5999.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16392.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14571.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14571.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15481.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14571.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5263.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 12HL 3.5X207MM ","code_information":[{"code":"384959","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":27441.00,"discounted_cash":27441.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12348.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14576.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9039.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24696.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21952.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21952.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23324.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21952.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7930.45,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 14 HL 251MM ","code_information":[{"code":"382374","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24014.00,"discounted_cash":24014.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10806.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12756.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7910.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21612.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19211.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19211.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20411.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19211.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6940.05,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 14H RT 3.5X237 ","code_information":[{"code":"359633","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28642.00,"discounted_cash":28642.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12888.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15214.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9434.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25777.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22913.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22913.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24345.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22913.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8277.54,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 14HL 237MM ","code_information":[{"code":"388619","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26037.00,"discounted_cash":26037.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11716.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13830.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8576.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23433.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20829.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20829.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22131.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20829.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7524.69,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 14JL 1MM 1.5MM ","code_information":[{"code":"914078","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 16HL 190.5MM ","code_information":[{"code":"383840","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 16HL 3.5X208MM ","code_information":[{"code":"357379","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8761.00,"discounted_cash":8761.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3942.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4653.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2885.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7884.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7008.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7008.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7446.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7008.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2531.93,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 17H 2MM ","code_information":[{"code":"913043","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36125.00,"discounted_cash":36125.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16256.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19189.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11899.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32512.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28900.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":30706.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28900.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10440.13,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 18HL 303MM ","code_information":[{"code":"409355","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21198.00,"discounted_cash":21198.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9539.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11260.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6982.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19078.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18018.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16958.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6126.22,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 1STP 135D 270MM ","code_information":[{"code":"742669","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12856.00,"discounted_cash":12856.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5785.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6829.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4234.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11570.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10284.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10284.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10927.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10284.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3715.38,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2.4MM ","code_information":[{"code":"387225","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7933.00,"discounted_cash":7933.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3569.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4214.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2613.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7139.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6743.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6346.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2292.64,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2.7 4HL 32MM ","code_information":[{"code":"387399","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8248.00,"discounted_cash":8248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3711.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4381.34,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2716.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7423.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6598.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6598.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7010.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6598.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2383.67,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2.7/3.5MM 20MM ","code_information":[{"code":"360275","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":35749.00,"discounted_cash":35749.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16087.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18989.87,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11775.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32174.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28599.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28599.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":30386.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":28599.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10331.46,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2.7/3.5X127MM ","code_information":[{"code":"389273","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14419.00,"discounted_cash":14419.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6488.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7659.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4749.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12977.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12256.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4167.09,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2.7MM 73MM ","code_information":[{"code":"174707","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8786.00,"discounted_cash":8786.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3953.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4667.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2894.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7907.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7028.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7028.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7468.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7028.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2539.15,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 20H 0.7MM ","code_information":[{"code":"388943","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9424.00,"discounted_cash":9424.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4240.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5006.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3104.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8481.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7539.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7539.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8010.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7539.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2723.54,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 218.5MM 14HL ","code_information":[{"code":"383849","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2H 2.7/3.5X82MM ","code_information":[{"code":"386964","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14419.00,"discounted_cash":14419.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6488.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7659.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4749.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12977.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12256.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11535.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4167.09,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2HL 95MM ","code_information":[{"code":"387850","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21325.00,"discounted_cash":21325.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9596.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11327.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7024.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19192.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17060.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17060.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18126.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17060.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6162.93,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2X2HL 1MM ","code_information":[{"code":"389084","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 2Y 6HL .4MM ","code_information":[{"code":"357396","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6991.00,"discounted_cash":6991.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3145.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3713.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2302.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6291.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5592.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5592.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5942.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5592.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2020.40,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3.5MM 154MM ","code_information":[{"code":"353568","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3.5MM 80MM ","code_information":[{"code":"360157","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4909.00,"discounted_cash":4909.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2209.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2607.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1617.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4418.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3927.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3927.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4172.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3927.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1418.70,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3.5X142MM 6HL ","code_information":[{"code":"354631","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13572.00,"discounted_cash":13572.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6107.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7209.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4470.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12214.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10857.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10857.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11536.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10857.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3922.31,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3D RIGHT ","code_information":[{"code":"383872","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11127.00,"discounted_cash":11127.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5007.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5910.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3665.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10014.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8901.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8901.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9457.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8901.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3215.70,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3HL 2.7MM 79MM ","code_information":[{"code":"381648","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10322.00,"discounted_cash":10322.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4644.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5483.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3400.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9289.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8257.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8257.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8773.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8257.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2983.06,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 3X5HL 1.3MM ","code_information":[{"code":"385609","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4.5MM 155MM ","code_information":[{"code":"384868","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23222.00,"discounted_cash":23222.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10449.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12335.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7649.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20899.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18577.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18577.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19738.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18577.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6711.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4.5X188MM ","code_information":[{"code":"357884","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7830.00,"discounted_cash":7830.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3523.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4159.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2579.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7047.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6264.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6264.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6655.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6264.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2262.87,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4H 23MM ","code_information":[{"code":"388125","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4H 58.5MM ","code_information":[{"code":"383777","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4H LT MD 88MM ","code_information":[{"code":"357873","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14605.00,"discounted_cash":14605.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6572.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7758.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4810.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13144.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11684.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11684.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12414.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11684.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4220.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4HL 121MM ","code_information":[{"code":"383790","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21780.00,"discounted_cash":21780.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9801.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11569.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7174.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19602.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18513.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17424.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6294.42,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4HL 2.7MM 92MM ","code_information":[{"code":"356927","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10793.00,"discounted_cash":10793.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4856.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5733.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3555.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9713.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8634.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8634.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9174.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8634.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3119.18,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4HL 60.5MM ","code_information":[{"code":"383881","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8782.00,"discounted_cash":8782.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3951.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4665.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2892.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7903.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7025.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7025.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7464.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7025.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2538.00,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 4HL RT 3.5MM ","code_information":[{"code":"438458","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19503.00,"discounted_cash":19503.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8776.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10359.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6424.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17552.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15602.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15602.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16577.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15602.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5636.37,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 52MM 2.4MM ","code_information":[{"code":"354573","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 5H 112MM ","code_information":[{"code":"383780","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25832.00,"discounted_cash":25832.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11624.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13721.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8509.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23248.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20665.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20665.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21957.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20665.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7465.45,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 5H 34MM ","code_information":[{"code":"389595","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 5HL 101X10X2MM ","code_information":[{"code":"355561","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 5HL 84MM ","code_information":[{"code":"383899","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19415.00,"discounted_cash":19415.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8736.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10313.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6395.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17473.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15532.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15532.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16502.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15532.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5610.94,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6H ","code_information":[{"code":"383879","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12214.00,"discounted_cash":12214.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5496.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6488.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4023.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10992.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10381.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9771.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3529.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6H 2.4MM 40MM ","code_information":[{"code":"388252","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6H 33MM ","code_information":[{"code":"919050","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6H 97MM ","code_information":[{"code":"383929","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13435.00,"discounted_cash":13435.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6045.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7136.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4425.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12091.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11419.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3882.72,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 1.5MM 2.3MM ","code_information":[{"code":"381002","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 12MM ","code_information":[{"code":"356964","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6541.00,"discounted_cash":6541.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2943.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3474.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2154.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5886.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5232.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5232.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5559.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5232.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1890.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 2.4MM 45MM ","code_information":[{"code":"174808","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12310.00,"discounted_cash":12310.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5539.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6539.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4054.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11079.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10463.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9848.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3557.59,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 2.7/3.5MM ","code_information":[{"code":"381200","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20803.00,"discounted_cash":20803.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9361.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11050.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6852.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18722.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16642.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16642.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17682.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16642.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6012.07,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 3.5X117MM ","code_information":[{"code":"387604","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19428.00,"discounted_cash":19428.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8742.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10320.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6399.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17485.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15542.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15542.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16513.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15542.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5614.69,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL 78X3.5MM ","code_information":[{"code":"350316","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12450.00,"discounted_cash":12450.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5602.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6613.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4101.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11205.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10582.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9960.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3598.05,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 6HL RT 36X3.5MM ","code_information":[{"code":"383936","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20164.00,"discounted_cash":20164.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9073.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10711.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6642.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18147.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16131.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16131.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17139.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16131.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5827.40,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 70MM 3.5MM ","code_information":[{"code":"383937","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22232.00,"discounted_cash":22232.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10004.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11809.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7323.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20008.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17785.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17785.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18897.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17785.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6425.05,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 7H ","code_information":[{"code":"383888","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17092.00,"discounted_cash":17092.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7691.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9079.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5630.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15382.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13673.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13673.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14528.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13673.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4939.59,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 7HL 2.4MM ","code_information":[{"code":"356920","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11632.00,"discounted_cash":11632.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5234.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6178.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3831.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10468.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9305.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9305.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9887.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9305.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3361.65,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 7HL 4.5MM 134MM ","code_information":[{"code":"171314","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8 HOLE LT CLAVC ","code_information":[{"code":"360230","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14610.00,"discounted_cash":14610.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6574.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7760.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4812.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13149.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12418.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11688.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4222.29,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8H 120MM ","code_information":[{"code":"383787","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13435.00,"discounted_cash":13435.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6045.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7136.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4425.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12091.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11419.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10748.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3882.72,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8H 2.7-3.5X169 ","code_information":[{"code":"388265","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14238.00,"discounted_cash":14238.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6407.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7563.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4690.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12814.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11390.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11390.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12102.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11390.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4114.78,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8H 97MM ","code_information":[{"code":"383910","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16771.00,"discounted_cash":16771.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7546.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8908.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5524.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15093.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13416.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13416.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14255.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13416.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4846.82,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8HL 123MM ","code_information":[{"code":"383799","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20423.00,"discounted_cash":20423.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9190.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10848.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6727.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18380.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16338.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16338.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17359.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16338.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5902.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8HL 199MM ","code_information":[{"code":"358872","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22823.00,"discounted_cash":22823.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10270.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12123.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7517.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20540.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18258.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18258.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19399.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18258.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6595.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8HL 3.5X147MM ","code_information":[{"code":"356127","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22106.00,"discounted_cash":22106.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9947.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11742.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7281.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19895.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17684.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17684.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18790.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17684.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6388.63,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 8HL 99MM ","code_information":[{"code":"383917","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14211.00,"discounted_cash":14211.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6394.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7548.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4681.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12789.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12079.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11368.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4106.98,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 93X10X2MM ","code_information":[{"code":"919875","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18018.00,"discounted_cash":18018.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8108.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9571.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5935.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16216.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14414.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14414.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15315.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14414.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5207.20,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN 9H 2.7-3.5X153 ","code_information":[{"code":"435440","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15056.00,"discounted_cash":15056.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6775.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7997.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4959.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13550.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12044.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12044.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12797.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12044.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4351.18,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN ACTB 6HL 70.5MM ","code_information":[{"code":"383889","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN ANT LAT RT 6HL ","code_information":[{"code":"358155","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18430.00,"discounted_cash":18430.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8293.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9790.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6070.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16587.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14744.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14744.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15665.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14744.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5326.27,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN BURR HL 10MM ","code_information":[{"code":"437136","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6180.00,"discounted_cash":6180.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2781.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3282.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2035.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5562.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5253.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4944.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1786.02,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CERV SPN L84MM ","code_information":[{"code":"24635","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18658.00,"discounted_cash":18658.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8396.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9911.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6145.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15859.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5392.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CLVCL RT 2.7MM ","code_information":[{"code":"389193","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15792.00,"discounted_cash":15792.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7106.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8388.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5201.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14212.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12633.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12633.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13423.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12633.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4563.89,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CMPR 10HL 127MM ","code_information":[{"code":"383920","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7697.00,"discounted_cash":7697.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3463.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4088.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2535.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6927.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6542.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6157.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2224.43,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CRNMXF 0.6X12MM ","code_information":[{"code":"357505","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2847.00,"discounted_cash":2847.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1281.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1512.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":937.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2562.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2277.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2277.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2419.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2277.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":822.78,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CRV 10HL 3.5MM ","code_information":[{"code":"173150","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN CRVD 8HL 4.5MM ","code_information":[{"code":"430950","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23976.00,"discounted_cash":23976.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10789.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12736.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7897.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21578.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19180.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19180.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20379.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19180.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6929.06,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN DIST RAD 4HL ","code_information":[{"code":"174703","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11478.00,"discounted_cash":11478.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5165.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6097.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3780.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10330.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9182.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9182.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9756.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9182.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3317.14,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN FEM 310MM 14 HL ","code_information":[{"code":"383865","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":26683.00,"discounted_cash":26683.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12007.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14174.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8789.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24014.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21346.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22680.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21346.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7711.39,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN FEM R 16H 343MM ","code_information":[{"code":"383869","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":32048.00,"discounted_cash":32048.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14421.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":17023.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10556.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28843.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25638.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25638.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27240.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25638.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9261.87,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN UPRFCL 3D 6X6HL ","code_information":[{"code":"437113","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12707.00,"discounted_cash":12707.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5718.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6749.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4185.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11436.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10165.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10165.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10800.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10165.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3672.32,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN W BAR 4H 2.4MM ","code_information":[{"code":"26045","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4113.00,"discounted_cash":4113.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1850.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2184.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1354.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3701.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3290.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3290.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3496.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3290.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1188.66,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BN XTN NTRL ","code_information":[{"code":"352401","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12616.00,"discounted_cash":12616.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5677.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6701.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4155.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11354.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10723.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10092.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3646.02,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE 100X100MM MESH ","code_information":[{"code":"23732","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25674.00,"discounted_cash":25674.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11553.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13638.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8457.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23106.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20539.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20539.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21822.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20539.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7419.79,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE 4 HL 46.5 ","code_information":[{"code":"381543","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE CERV 30 SPNL ","code_information":[{"code":"24151","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22586.00,"discounted_cash":22586.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10163.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11997.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7439.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20327.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19198.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6527.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE CERV 62 SPNL ","code_information":[{"code":"24588","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21822.00,"discounted_cash":21822.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9819.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11591.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7188.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19639.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17457.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17457.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18548.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17457.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6306.56,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE LCP 4.5MM THCK ","code_information":[{"code":"385132","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12963.00,"discounted_cash":12963.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5833.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6885.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4270.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11666.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11018.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10370.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3746.31,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE SS BRD L178MM ","code_information":[{"code":"171302","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE TI 2.4 H 8HLES ","code_information":[{"code":"174910","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10020.00,"discounted_cash":10020.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4509.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5322.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3300.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9018.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8016.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8016.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8517.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8016.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2895.78,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE TI L35MM ANT S ","code_information":[{"code":"22304","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":54992.00,"discounted_cash":54992.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":24746.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":29211.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":18114.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":49492.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43993.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43993.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":46743.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":43993.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15892.69,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BNE VEC TI 54X45 ","code_information":[{"code":"171046","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BONE LCP 2.4 X 65M ","code_information":[{"code":"24930","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12161.00,"discounted_cash":12161.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5472.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6459.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4005.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10944.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10336.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3514.53,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BOW 5MM DARCO FOOT ","code_information":[{"code":"382657","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":34419.00,"discounted_cash":34419.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":15488.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18283.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11337.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":30977.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27535.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":29256.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27535.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9947.09,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BRD 250MM SS 4.5MM ","code_information":[{"code":"22052","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BROAD LCP 4.5MM 12 ","code_information":[{"code":"21996","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10237.00,"discounted_cash":10237.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4606.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5437.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3372.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9213.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8189.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8189.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8701.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8189.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2958.49,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE BS STM TIB NP SZ5 ","code_information":[{"code":"745559","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11033.00,"discounted_cash":11033.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4964.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5860.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3634.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9929.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9378.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8826.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3188.54,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CALC LOCK LG LT TI ","code_information":[{"code":"383413","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15880.00,"discounted_cash":15880.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7146.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8435.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5230.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14292.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13498.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12704.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4589.32,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CBL RDY 16X187 6HL ","code_information":[{"code":"25044","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8912.00,"discounted_cash":8912.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4010.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4734.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2935.61,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8020.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7129.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7129.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7575.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7129.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2575.57,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CERV 24MM 1LVL ","code_information":[{"code":"25289","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18658.00,"discounted_cash":18658.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8396.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9911.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6145.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15859.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5392.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CERV 40MM 2LVL ","code_information":[{"code":"26658","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18658.00,"discounted_cash":18658.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8396.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9911.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6145.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15859.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5392.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CERV 54MM 3LVL ","code_information":[{"code":"25365","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CERV 69MM 4LVL ","code_information":[{"code":"174996","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":22586.00,"discounted_cash":22586.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10163.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11997.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7439.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20327.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19198.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18068.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6527.35,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CERV FX 35 ","code_information":[{"code":"21181","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23171.00,"discounted_cash":23171.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10426.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12308.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7632.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20853.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18536.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18536.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19695.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18536.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6696.42,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CITADEL 20MM ","code_information":[{"code":"24383","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":53421.00,"discounted_cash":53421.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":24039.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":28377.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":17596.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":48078.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45407.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42736.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15438.67,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CMPR LK 8H 4.5X157 ","code_information":[{"code":"380949","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8775.00,"discounted_cash":8775.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3948.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4661.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2890.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7897.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7458.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2535.97,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CNDRL 9H 80X3.5MM ","code_information":[{"code":"744687","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8041.00,"discounted_cash":8041.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3618.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4271.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2648.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7236.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6834.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2323.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE COND 8H 70MM ","code_information":[{"code":"744689","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8041.00,"discounted_cash":8041.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3618.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4271.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2648.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7236.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6834.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6432.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2323.85,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CRNL LT 100D 2MM ","code_information":[{"code":"352860","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5103.00,"discounted_cash":5103.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2296.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2710.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1680.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4592.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4082.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4082.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4337.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4082.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1474.77,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CRNMXF ORBT LT LG ","code_information":[{"code":"385532","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36551.00,"discounted_cash":36551.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16447.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19415.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12039.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":32895.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29240.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29240.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31068.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29240.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10563.24,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CRVCL 43MM 2LV 6HL ","code_information":[{"code":"359177","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18658.00,"discounted_cash":18658.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8396.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9911.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6145.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15859.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14926.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5392.16,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE CSPN PYR 3LVL 51MM ","code_information":[{"code":"353018","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DCP 124MM SS 7HL ","code_information":[{"code":"744695","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7669.00,"discounted_cash":7669.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3451.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4073.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2526.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6902.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6135.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6135.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6518.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6135.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2216.34,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DIST 152MM 11HL LT ","code_information":[{"code":"381148","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16575.00,"discounted_cash":16575.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7458.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8804.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5459.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14917.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13260.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14088.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13260.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4790.18,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DIST RADL LT ","code_information":[{"code":"24335","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14699.00,"discounted_cash":14699.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6614.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7808.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4841.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13229.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11759.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11759.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12494.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11759.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4248.01,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DISTAL RADIUS VOLA ","code_information":[{"code":"174618","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12161.00,"discounted_cash":12161.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5472.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6459.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4005.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10944.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10336.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9728.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3514.53,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE DYN SPNL 35MM ","code_information":[{"code":"173785","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20622.00,"discounted_cash":20622.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9279.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10954.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6792.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18559.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17528.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16497.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5959.76,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE EPICONDYL LT 10 ","code_information":[{"code":"22980","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12704.00,"discounted_cash":12704.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5716.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6748.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4184.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11433.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10163.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10163.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10798.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10163.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3671.46,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE FEM 7HL 3.5-4.5MM ","code_information":[{"code":"435576","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":34809.00,"discounted_cash":34809.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":15664.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":18490.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":11466.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":31328.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27847.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27847.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":29587.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":27847.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10059.80,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE FIB LCK RT 6 HL ","code_information":[{"code":"354603","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8748.00,"discounted_cash":8748.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3936.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4646.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2881.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7873.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6998.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6998.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7435.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6998.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2528.17,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE FRAG 7HL LCK 97MM ","code_information":[{"code":"389778","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2914.00,"discounted_cash":2914.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1311.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1547.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":959.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2622.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2331.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2331.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2476.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2331.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":842.15,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE FX C-SHAPE 4H ","code_information":[{"code":"171731","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HAND PRFL 57-10320 ","code_information":[{"code":"385863","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HAND PRFL 57-15321 ","code_information":[{"code":"351457","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6271.00,"discounted_cash":6271.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2821.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3331.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2065.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5643.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5016.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5016.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5330.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5016.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1812.32,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HIP 130D 2HL 47MM ","code_information":[{"code":"386884","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HND WRST PRFL 5240 ","code_information":[{"code":"171106","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6814.00,"discounted_cash":6814.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3066.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3619.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2244.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6132.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5451.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5451.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5791.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5451.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1969.25,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HND WRST PRFL13102 ","code_information":[{"code":"25877","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5160.00,"discounted_cash":5160.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2322.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2740.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1699.70,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4644.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4128.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4128.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4386.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4128.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1491.24,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE HUM 3.5MM 127MM ","code_information":[{"code":"380533","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":20854.00,"discounted_cash":20854.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9384.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11077.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6869.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18768.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16683.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16683.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17725.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16683.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6026.81,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE KNBCK RADS VLR 2.8 ","code_information":[{"code":"387241","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21774.00,"discounted_cash":21774.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9798.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11566.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7172.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19596.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17419.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17419.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18507.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17419.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6292.69,"methodology":"percent of total billed charges"}]}]},{"description":"PLATE L Y MED PRFL R 5HL ","code_information":[{"code":"358688","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.0MM 12MM ","code_information":[{"code":"424727","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6951.00,"discounted_cash":6951.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3127.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3692.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2289.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6255.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5560.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5560.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5908.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5560.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2008.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.0MM 30MM ","code_information":[{"code":"387360","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4954.00,"discounted_cash":4954.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2229.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2631.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1631.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4458.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4210.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1431.71,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.0MM 50MM ","code_information":[{"code":"356213","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5157.00,"discounted_cash":5157.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2320.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2739.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1698.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4641.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4125.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4125.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4383.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4125.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1490.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.0MM 65MM ","code_information":[{"code":"390649","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5101.00,"discounted_cash":5101.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2295.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2709.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1680.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4590.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4080.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4080.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4335.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4080.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1474.19,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.0MM 85MM ","code_information":[{"code":"390012","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4954.00,"discounted_cash":4954.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2229.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2631.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1631.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4458.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4210.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3963.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1431.71,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 25MM FORT ","code_information":[{"code":"381263","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16694.00,"discounted_cash":16694.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7512.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8867.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5499.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4824.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 34MM ","code_information":[{"code":"356896","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2424.00,"discounted_cash":2424.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1090.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1287.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":798.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2060.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":700.54,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 38MM ","code_information":[{"code":"357785","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4599.00,"discounted_cash":4599.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2069.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2442.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1514.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4139.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3909.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1329.11,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 45MM ","code_information":[{"code":"358215","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 50MM MESA ","code_information":[{"code":"385781","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5MM 80MM ","code_information":[{"code":"358027","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2990.00,"discounted_cash":2990.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1345.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1588.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":984.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2691.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2392.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2392.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2541.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2392.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":864.11,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.5X30MM NLCK ","code_information":[{"code":"357777","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4134.00,"discounted_cash":4134.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1860.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2195.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1361.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3720.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3307.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3307.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3513.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3307.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1194.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5.7MM 65MM ","code_information":[{"code":"354964","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 59215555 ANK 3 ","code_information":[{"code":"356892","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 120MM ","code_information":[{"code":"411616","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3136.00,"discounted_cash":3136.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1411.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1665.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1033.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2822.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2508.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2508.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2665.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2508.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":906.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 20MM ","code_information":[{"code":"354503","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3852.00,"discounted_cash":3852.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1733.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2046.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1268.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3466.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3081.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3081.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3274.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3081.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1113.23,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 25MM ","code_information":[{"code":"356821","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5388.00,"discounted_cash":5388.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2424.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2862.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1774.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4849.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4579.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1557.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 27.5MM ","code_information":[{"code":"388700","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4675.00,"discounted_cash":4675.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2103.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2483.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1539.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4207.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3740.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3740.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3973.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3740.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1351.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 30MM ","code_information":[{"code":"353950","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4063.00,"discounted_cash":4063.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1828.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2158.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1338.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3656.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3250.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3250.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3453.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3250.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1174.21,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 32MM ","code_information":[{"code":"350545","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3892.00,"discounted_cash":3892.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1751.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2067.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1282.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3502.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3113.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3113.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3308.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3113.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1124.79,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 35MM ","code_information":[{"code":"356440","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5821.00,"discounted_cash":5821.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2619.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3092.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1917.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5238.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4656.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4656.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4947.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4656.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1682.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 38MM ","code_information":[{"code":"390511","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 4.3MM 66MM ","code_information":[{"code":"174562","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2964.00,"discounted_cash":2964.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1333.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1574.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":976.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2667.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2519.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":856.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 4.4MM 20MM ","code_information":[{"code":"359892","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3614.00,"discounted_cash":3614.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1626.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1919.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1190.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3252.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2891.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2891.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3071.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2891.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1044.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 4.4MM 95MM ","code_information":[{"code":"23715","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5508.00,"discounted_cash":5508.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2478.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2925.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1814.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4957.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4681.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1591.81,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 40MM ","code_information":[{"code":"390512","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 42MM ","code_information":[{"code":"914050","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2138.00,"discounted_cash":2138.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":962.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1135.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":704.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1924.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1710.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1710.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1817.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1710.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":617.88,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 44MM TI T15 ","code_information":[{"code":"383435","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 46MM DIST ","code_information":[{"code":"356983","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4191.00,"discounted_cash":4191.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1885.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2226.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1380.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3771.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3352.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3352.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3562.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3352.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1211.20,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 50MM ","code_information":[{"code":"387369","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4251.00,"discounted_cash":4251.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1912.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2258.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1400.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3825.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3400.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3400.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3613.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3400.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1228.54,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 52MM TI T25 ","code_information":[{"code":"386867","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3632.00,"discounted_cash":3632.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1634.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1929.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1196.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3268.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3087.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1049.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 58MM ","code_information":[{"code":"23374","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3832.00,"discounted_cash":3832.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1724.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2035.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1262.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3448.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3065.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3065.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3257.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3065.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1107.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 5MM 65MM ","code_information":[{"code":"355630","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3493.00,"discounted_cash":3493.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1571.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1855.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1150.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3143.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2969.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2794.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1009.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8.0MM 2.7MM ","code_information":[{"code":"389380","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3513.00,"discounted_cash":3513.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1580.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1866.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1157.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3161.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2810.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2986.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2810.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1015.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8.5MM 70MM VRST ","code_information":[{"code":"385109","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8MM 130MM ","code_information":[{"code":"389776","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5277.00,"discounted_cash":5277.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2374.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2803.14,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1738.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4749.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4221.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4221.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4485.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4221.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1525.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8MM 150MM ","code_information":[{"code":"388057","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6155.00,"discounted_cash":6155.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2769.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3269.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2027.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5539.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5231.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1778.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8MM 20MM ","code_information":[{"code":"385646","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8MM 55MM V ","code_information":[{"code":"389104","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8MM 85MM ","code_information":[{"code":"384424","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6155.00,"discounted_cash":6155.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2769.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3269.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2027.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5539.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5231.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4924.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1778.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 8X135MM ","code_information":[{"code":"410057","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 95MM ","code_information":[{"code":"358059","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9147.00,"discounted_cash":9147.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4116.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4858.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3013.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8232.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7317.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7317.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7774.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7317.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2643.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN 9MM 25MM ","code_information":[{"code":"381038","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN ACTRL 5.5X55 ","code_information":[{"code":"380898","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN ANTIROT 115MM ","code_information":[{"code":"390272","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN BSPLT 4.5X20MM ","code_information":[{"code":"359792","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2318.00,"discounted_cash":2318.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1043.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1231.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":763.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2086.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1854.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1970.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1854.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":669.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CAN 4X6X55X15MM ","code_information":[{"code":"353406","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":449.00,"discounted_cash":449.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":202.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":238.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":147.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":404.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":381.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":129.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANC 37592-20 ","code_information":[{"code":"351606","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7099.00,"discounted_cash":7099.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3194.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3770.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2338.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6389.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6034.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5679.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2051.61,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANC 4X2.5X10MM ","code_information":[{"code":"357049","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":459.00,"discounted_cash":459.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":206.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":243.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":151.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":413.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":390.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":367.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":132.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANC 5MM 36MM ","code_information":[{"code":"174846","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4661.00,"discounted_cash":4661.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2097.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2475.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1535.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4194.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3728.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3961.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3728.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1347.03,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANC 6.5X60MM ","code_information":[{"code":"174614","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2557.00,"discounted_cash":2557.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1150.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1358.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":842.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2301.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2045.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2173.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2045.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":738.97,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANN 3.0X24MM ","code_information":[{"code":"390704","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANN 4X50MM ","code_information":[{"code":"412626","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4048.00,"discounted_cash":4048.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1821.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2150.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1333.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3643.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3238.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3238.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3440.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3238.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1169.87,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANN 5X85MM ","code_information":[{"code":"424724","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6727.00,"discounted_cash":6727.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3027.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3573.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2215.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6054.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5381.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5381.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5717.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5381.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1944.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CANN 6.5X70MM ","code_information":[{"code":"25186","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6412.00,"discounted_cash":6412.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2885.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3406.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2112.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5770.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5129.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5129.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5450.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5129.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1853.07,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CMP HDLS 2.5X28 ","code_information":[{"code":"387074","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CNDRL 5X4.4X40 ","code_information":[{"code":"23718","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5508.00,"discounted_cash":5508.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2478.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2925.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1814.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4957.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4681.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1591.81,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 2.7MM 10MM ","code_information":[{"code":"175043","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1169.00,"discounted_cash":1169.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":526.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":620.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":385.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1052.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":935.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":935.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":993.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":935.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":337.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 2.7MM 30MM ","code_information":[{"code":"354468","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":908.00,"discounted_cash":908.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":408.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":482.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":299.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":817.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":726.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":726.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":771.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":726.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":262.41,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 3.5MM 18MM ","code_information":[{"code":"357031","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4599.00,"discounted_cash":4599.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2069.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2442.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1514.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4139.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3909.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3679.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1329.11,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 3.5MM 28MM ","code_information":[{"code":"356993","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5239.00,"discounted_cash":5239.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2357.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2782.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1725.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4715.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4191.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4191.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4453.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4191.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1514.07,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 3.5X18MM ","code_information":[{"code":"380005","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":667.00,"discounted_cash":667.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":300.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":354.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":219.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":600.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":566.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":192.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 3.5X28MM ","code_information":[{"code":"359648","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":667.00,"discounted_cash":667.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":300.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":354.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":219.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":600.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":566.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":533.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":192.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 3.5X50MM ","code_information":[{"code":"351396","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1109.00,"discounted_cash":1109.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":499.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":589.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":365.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":998.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":942.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":320.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 32.5X5.0 ","code_information":[{"code":"350310","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5249.00,"discounted_cash":5249.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2362.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2788.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1729.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4724.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4199.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4199.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4461.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4199.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1516.96,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 36X4.5MM ","code_information":[{"code":"384176","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1109.00,"discounted_cash":1109.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":499.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":589.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":365.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":998.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":942.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":320.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 4.5X28MM ","code_information":[{"code":"381268","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4516.00,"discounted_cash":4516.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2032.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2398.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1487.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4064.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3612.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3612.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3838.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3612.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1305.12,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT 4.5X8X70MM ","code_information":[{"code":"388146","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":559.00,"discounted_cash":559.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":251.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":296.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":184.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":503.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":447.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":447.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":475.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":447.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":161.55,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CORT T6 2X20MM ","code_information":[{"code":"352954","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1118.00,"discounted_cash":1118.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":503.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":593.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":368.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1006.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":894.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":894.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":950.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":894.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":323.10,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CPTR HEX 4.5X35 ","code_information":[{"code":"20865","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3473.00,"discounted_cash":3473.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1562.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1844.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1144.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3125.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2952.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1003.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CPTR HEX 5X75 ","code_information":[{"code":"20881","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3473.00,"discounted_cash":3473.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1562.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1844.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1144.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3125.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2952.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2778.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1003.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CRNFCL 1.3X4MM ","code_information":[{"code":"383027","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2221.00,"discounted_cash":2221.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":999.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1179.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":731.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1998.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1776.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1776.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1887.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1776.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":641.87,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CRTX 1.5X16MM ","code_information":[{"code":"20132","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":851.00,"discounted_cash":851.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":382.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":452.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":280.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":765.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":680.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":680.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":723.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":680.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":245.94,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN CRTX 3.5MM 34MM ","code_information":[{"code":"388071","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":839.00,"discounted_cash":839.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":377.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":445.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":276.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":755.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":713.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":671.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":242.47,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN DARCO HD 4.0X42 ","code_information":[{"code":"355903","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN EVOS 4X4.5X40MM ","code_information":[{"code":"384345","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2737.00,"discounted_cash":2737.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1231.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1453.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":901.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2463.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2189.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2189.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2326.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2189.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":790.99,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN F/T 4MM 36MM ","code_information":[{"code":"384238","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1360.00,"discounted_cash":1360.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":612.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":722.43,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":447.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1224.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1088.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1088.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1156.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1088.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":393.04,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN FEM STRL 105MM ","code_information":[{"code":"385943","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN FL THRD 3.5X26 ","code_information":[{"code":"384110","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4264.00,"discounted_cash":4264.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1918.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2265.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1404.56,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3837.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3411.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3411.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3624.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3411.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1232.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN FT 2.7X55MM ","code_information":[{"code":"384084","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2246.00,"discounted_cash":2246.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1010.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1193.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":739.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2021.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1796.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1796.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1909.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1796.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":649.09,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN FT LCK 4X35MM ","code_information":[{"code":"391192","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6446.00,"discounted_cash":6446.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2900.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3424.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2123.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5801.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5156.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5156.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5479.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5156.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1862.89,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HD 6.5X85X16MM ","code_information":[{"code":"386985","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4277.00,"discounted_cash":4277.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1924.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2271.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1408.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3849.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3635.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1236.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HDLS 2.5X28MM ","code_information":[{"code":"389877","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HDLS CMPR 3X32 ","code_information":[{"code":"386236","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HEADED 4MM 32MM ","code_information":[{"code":"387319","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4277.00,"discounted_cash":4277.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1924.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2271.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1408.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3849.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3635.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1236.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HEADED 4MM 50MM ","code_information":[{"code":"385482","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4277.00,"discounted_cash":4277.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1924.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2271.94,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1408.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3849.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3635.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3421.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1236.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HIP 4.5MM 25MM ","code_information":[{"code":"380780","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2438.00,"discounted_cash":2438.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1097.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1295.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":803.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2194.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2072.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":704.58,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HND 1.5MM 12MM ","code_information":[{"code":"360038","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3087.00,"discounted_cash":3087.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1389.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1639.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1016.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2778.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2469.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2469.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2623.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2469.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":892.14,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HUM ","code_information":[{"code":"388491","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6842.00,"discounted_cash":6842.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3078.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3634.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2253.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6157.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5473.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5473.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5815.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5473.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1977.34,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HUM 3.5MM 70MM ","code_information":[{"code":"380489","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":876.00,"discounted_cash":876.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":394.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":465.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":288.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":788.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":700.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":700.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":744.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":700.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":253.16,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN HXLBE 3.5X18MM ","code_information":[{"code":"381702","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN INTFR 35X11MM ","code_information":[{"code":"385970","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN L45MM OD7.5MM M ","code_information":[{"code":"174574","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 14X2.7MM ","code_information":[{"code":"437111","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1608.00,"discounted_cash":1608.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":723.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":854.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":529.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1447.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1286.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1286.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1366.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1286.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":464.71,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 2.4MM 14MM ","code_information":[{"code":"389704","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3562.00,"discounted_cash":3562.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1602.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1892.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1173.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3205.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2849.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2849.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3027.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2849.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1029.42,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 2.4X36MM ","code_information":[{"code":"384006","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3173.00,"discounted_cash":3173.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1427.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1685.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1045.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2855.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2538.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2538.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2697.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2538.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":917.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 2.7MM 16MM ","code_information":[{"code":"174201","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2808.00,"discounted_cash":2808.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1263.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1491.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":924.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2527.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2246.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2246.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2386.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2246.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":811.51,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 2.7MM 22MM ","code_information":[{"code":"21541","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3257.00,"discounted_cash":3257.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1465.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1730.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1072.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2931.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2768.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2605.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":941.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 2.7X12MM ","code_information":[{"code":"384029","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4127.00,"discounted_cash":4127.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1857.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2192.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1359.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3714.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3507.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1192.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 20MM ","code_information":[{"code":"391137","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1568.00,"discounted_cash":1568.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":705.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":832.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":516.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1411.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1254.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1254.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1332.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1254.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":453.15,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 3.5MM 14MM ","code_information":[{"code":"175229","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4562.00,"discounted_cash":4562.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2052.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2423.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1502.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4105.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3649.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3649.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3877.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3649.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1318.42,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 3.5MM 36MM ","code_information":[{"code":"384123","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4127.00,"discounted_cash":4127.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1857.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2192.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1359.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3714.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3507.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3301.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1192.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 3.5MN 12MM ","code_information":[{"code":"384613","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1945.00,"discounted_cash":1945.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":875.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1033.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":640.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1750.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1556.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1556.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1653.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1556.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":562.11,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 3.5X40MM ","code_information":[{"code":"383517","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5022.00,"discounted_cash":5022.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2259.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2667.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1654.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4519.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4268.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4017.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1451.36,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 3.5XX20 ","code_information":[{"code":"352037","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3222.00,"discounted_cash":3222.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1449.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1711.53,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1061.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2899.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2577.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2577.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2738.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2577.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":931.16,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 4.0X30MM ","code_information":[{"code":"386473","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4055.00,"discounted_cash":4055.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1824.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2154.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1335.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3649.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3446.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1171.89,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 4MM 30MM ","code_information":[{"code":"24477","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2964.00,"discounted_cash":2964.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1333.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1574.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":976.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2667.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2519.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":856.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 4X90MM ","code_information":[{"code":"389226","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4055.00,"discounted_cash":4055.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1824.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2154.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1335.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3649.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3446.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3244.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1171.89,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5MM 37MM ","code_information":[{"code":"386902","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5561.00,"discounted_cash":5561.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2502.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2954.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1831.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5004.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4448.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4448.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4726.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4448.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1607.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5MM 52MM ","code_information":[{"code":"915606","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5116.00,"discounted_cash":5116.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2302.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2717.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1685.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4604.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4348.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4092.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1478.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5MM 66MM ","code_information":[{"code":"920385","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7112.00,"discounted_cash":7112.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3200.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3777.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2342.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6400.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6045.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2055.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5X18MM ","code_information":[{"code":"390593","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1352.00,"discounted_cash":1352.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":608.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":718.18,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":445.35,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1216.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1081.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1081.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1149.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1081.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":390.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5X34MM ","code_information":[{"code":"23401","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3465.00,"discounted_cash":3465.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1559.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1840.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1141.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3118.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2772.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2772.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2945.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2772.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1001.38,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5X4.4X70MM ","code_information":[{"code":"24394","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4023.00,"discounted_cash":4023.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1810.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2137.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1325.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3620.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3218.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3218.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3419.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3218.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1162.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5X45MM ","code_information":[{"code":"386430","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4008.00,"discounted_cash":4008.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1803.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1320.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3607.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3406.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1158.31,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 5X60MM ","code_information":[{"code":"389959","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5149.00,"discounted_cash":5149.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2317.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2735.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1696.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4634.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4119.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4119.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4376.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4119.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1488.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK 90D 34MM ","code_information":[{"code":"174061","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3393.00,"discounted_cash":3393.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1526.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1802.36,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1117.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3053.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2714.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2714.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2884.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2714.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":980.58,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK LP 5X80MM ","code_information":[{"code":"408374","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7112.00,"discounted_cash":7112.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3200.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3777.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2342.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6400.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6045.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2055.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCK ST 5X48MM ","code_information":[{"code":"386037","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6141.00,"discounted_cash":6141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2763.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3262.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2022.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5526.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4912.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4912.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5219.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4912.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1774.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCKG 5X55MM ","code_information":[{"code":"386434","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4008.00,"discounted_cash":4008.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1803.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2129.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1320.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3607.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3406.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3206.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1158.31,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LCKNG 4.0X44MM ","code_information":[{"code":"351618","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3408.00,"discounted_cash":3408.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1533.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1810.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1122.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3067.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2726.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2726.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2896.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2726.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":984.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LGKNG 4.5X85MM ","code_information":[{"code":"388791","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5460.00,"discounted_cash":5460.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2457.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2900.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1798.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4914.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4368.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4368.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4641.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4368.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1577.94,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LNGE/WHT 6.5X50 ","code_information":[{"code":"25530","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3991.00,"discounted_cash":3991.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1795.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2120.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1314.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3591.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3192.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3192.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3392.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3192.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1153.40,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN LPRO 5X4.3X27MM ","code_information":[{"code":"356824","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5388.00,"discounted_cash":5388.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2424.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2862.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1774.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4849.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4579.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4310.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1557.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN MICRO 16MM ","code_information":[{"code":"357390","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN MINI 20MM ","code_information":[{"code":"24822","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN MINI 4X30MM ","code_information":[{"code":"387055","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN MTRSL 2.7X48MM ","code_information":[{"code":"359256","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1131.00,"discounted_cash":1131.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":508.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":600.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":372.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1017.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":961.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":326.86,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN MXLFCL 14X2MM ","code_information":[{"code":"172293","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2948.00,"discounted_cash":2948.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1326.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1565.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":971.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2653.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2358.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2358.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2505.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2358.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":851.97,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN N-LCK SM 2.7X36 ","code_information":[{"code":"380894","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCK 2.7MM 18MM ","code_information":[{"code":"350244","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCK 2.7MM 38MM ","code_information":[{"code":"381637","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2110.00,"discounted_cash":2110.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":949.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1120.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":695.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1899.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1793.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":609.79,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCK 3.5MM 22MM ","code_information":[{"code":"175143","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2006.00,"discounted_cash":2006.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":902.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1065.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":660.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1805.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1604.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1604.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1604.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":579.73,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCK 3.5MM 38MM ","code_information":[{"code":"386314","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCK 3MM 14MM ","code_information":[{"code":"357540","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2167.00,"discounted_cash":2167.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":975.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1151.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":713.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1950.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1841.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1733.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":626.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCKG 2.4X32MM ","code_information":[{"code":"384003","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1850.00,"discounted_cash":1850.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":832.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":982.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":609.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1665.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1480.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1480.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1572.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1480.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":534.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NLCKG 2.7X26MM ","code_information":[{"code":"383554","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1713.00,"discounted_cash":1713.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":770.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":909.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":564.26,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1541.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1370.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1456.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1370.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":495.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NS LCK 5X30MM ","code_information":[{"code":"24785","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2964.00,"discounted_cash":2964.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1333.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1574.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":976.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2667.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2519.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":856.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN NS LCK 5X46MM ","code_information":[{"code":"24369","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2964.00,"discounted_cash":2964.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1333.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1574.48,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":976.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2667.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2519.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2371.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":856.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN TI XIA 6.5X45MM ","code_information":[{"code":"173733","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN TWSTOF 2X13MM ","code_information":[{"code":"384396","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN VAR 5X12MM ","code_information":[{"code":"355001","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6319.00,"discounted_cash":6319.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2843.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3356.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2081.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5687.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5055.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5055.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5371.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5055.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1826.19,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN XIA 0382-1530 ","code_information":[{"code":"173868","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BN XL25 5X80MM ","code_information":[{"code":"913016","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5819.00,"discounted_cash":5819.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2618.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3091.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1916.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5237.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4946.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1681.69,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE 1.2X9 PRFL ","code_information":[{"code":"171498","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2338.00,"discounted_cash":2338.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1052.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1241.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":770.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2104.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1987.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":675.68,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE 2.3X14 ","code_information":[{"code":"171416","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2338.00,"discounted_cash":2338.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1052.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1241.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":770.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2104.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1987.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1870.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":675.68,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE 3.5X28 CORT ","code_information":[{"code":"351374","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1109.00,"discounted_cash":1109.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":499.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":589.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":365.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":998.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":942.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":887.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":320.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE 4.5X30MM ","code_information":[{"code":"173869","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE 6 4.5 CORT ","code_information":[{"code":"360241","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2032.00,"discounted_cash":2032.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1079.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":669.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1727.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":587.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CANC 4.0X10 ","code_information":[{"code":"744445","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":473.00,"discounted_cash":473.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":212.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":251.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":155.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":425.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":378.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":378.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":402.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":378.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":136.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CANC 4.0X26 ","code_information":[{"code":"20169","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":449.00,"discounted_cash":449.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":202.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":238.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":147.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":404.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":381.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":359.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":129.76,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CANC 6.5X115 ","code_information":[{"code":"20220","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1198.00,"discounted_cash":1198.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":539.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":636.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":394.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1078.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1018.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":346.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CANC 6.5X50 ","code_information":[{"code":"742867","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":898.00,"discounted_cash":898.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":404.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":477.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":295.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":808.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":259.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CANC 6.5X85 ","code_information":[{"code":"744547","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":970.00,"discounted_cash":970.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":436.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":515.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":319.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":873.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":824.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":280.33,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE CP LCK 2.3X6 ","code_information":[{"code":"26183","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3133.00,"discounted_cash":3133.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1409.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1664.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1032.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2819.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2506.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2506.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2663.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2506.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":905.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE L26 SPNL ","code_information":[{"code":"21829","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE L6 OD3.5 ","code_information":[{"code":"380647","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3503.00,"discounted_cash":3503.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1576.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1860.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1153.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3152.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2802.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2802.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2977.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2802.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1012.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE NLK REV 4.5X35 ","code_information":[{"code":"359791","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1996.00,"discounted_cash":1996.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":898.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1060.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":657.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1796.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1596.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1596.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1696.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1596.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":576.84,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE SPNL 6X30 LMBR ","code_information":[{"code":"173944","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4178.00,"discounted_cash":4178.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1880.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2219.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1376.23,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3760.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3342.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3342.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3551.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3342.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1207.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE TI 14 4.5 S ","code_information":[{"code":"357265","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE TI 54X4 HUM/TI ","code_information":[{"code":"174297","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4071.00,"discounted_cash":4071.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1831.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2162.52,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1340.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3663.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3460.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1176.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE TI L12MM OD3.5 ","code_information":[{"code":"23027","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE TI L28MM OD5.0 ","code_information":[{"code":"359926","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4151.00,"discounted_cash":4151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1867.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2205.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1367.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3735.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3528.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1199.64,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNE TI L68MM OD5MM ","code_information":[{"code":"359465","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5069.00,"discounted_cash":5069.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2281.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2692.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1669.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4562.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4055.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4055.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4308.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4055.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1464.94,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BNNON-LOCKING3.5MM ","code_information":[{"code":"352732","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1882.00,"discounted_cash":1882.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":846.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":999.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":619.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1693.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1505.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1505.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1599.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1505.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":543.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BONE CANN 6.5 X 17 ","code_information":[{"code":"387277","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6272.00,"discounted_cash":6272.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2822.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3331.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2066.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5644.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5331.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1812.61,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BONE L20MM OD4MM L ","code_information":[{"code":"353512","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4024.00,"discounted_cash":4024.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1810.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2137.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1325.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3621.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3219.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3420.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3219.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1162.94,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BONE LOCKING 42X45 ","code_information":[{"code":"22013","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4151.00,"discounted_cash":4151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1867.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2205.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1367.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3735.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3528.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1199.64,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW BONE TITANIUM L50M ","code_information":[{"code":"352525","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC 140/50MM ","code_information":[{"code":"355871","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6500.00,"discounted_cash":6500.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2925.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3452.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2141.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5850.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5200.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5200.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5525.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5200.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1878.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC 4X40 ACMD ","code_information":[{"code":"381022","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2110.00,"discounted_cash":2110.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":949.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1120.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":695.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1899.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1793.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1688.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":609.79,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC 6.5X120X16 ","code_information":[{"code":"20219","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1198.00,"discounted_cash":1198.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":539.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":636.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":394.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1078.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1018.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":958.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":346.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC 6.5X70X16 ","code_information":[{"code":"744541","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":898.00,"discounted_cash":898.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":404.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":477.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":295.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":808.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":259.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC 6.5X90MM ","code_information":[{"code":"352682","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6329.00,"discounted_cash":6329.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2848.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3361.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2084.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5696.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5063.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5379.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5063.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1829.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC FXANG 6X60MM ","code_information":[{"code":"355987","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5448.00,"discounted_cash":5448.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2451.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2893.98,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1794.57,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4903.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4358.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4358.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4630.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4358.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1574.47,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC LF 6.5X 110 M ","code_information":[{"code":"744987","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":970.00,"discounted_cash":970.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":436.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":515.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":319.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":873.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":824.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":776.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":280.33,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC POLY 4.0X16 ","code_information":[{"code":"175187","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC SS 6.5X55X32 ","code_information":[{"code":"384920","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":867.00,"discounted_cash":867.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":390.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":460.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":285.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":780.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":736.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":250.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC SS 6.5X75X32 ","code_information":[{"code":"384924","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":867.00,"discounted_cash":867.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":390.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":460.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":285.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":780.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":736.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":250.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC SS 6.5X95X32 ","code_information":[{"code":"384927","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":867.00,"discounted_cash":867.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":390.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":460.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":285.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":780.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":736.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":693.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":250.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC TI F-T 6X25MM ","code_information":[{"code":"384880","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1257.00,"discounted_cash":1257.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":565.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":667.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":414.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1131.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1005.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1005.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1068.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1005.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":363.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANC XPN HD TI L16 ","code_information":[{"code":"20386","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4741.00,"discounted_cash":4741.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2133.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2518.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1561.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4266.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4029.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1370.15,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 3.5X20 ","code_information":[{"code":"746353","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5197.00,"discounted_cash":5197.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2338.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2760.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1711.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4677.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4417.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1501.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 3.5X40 ","code_information":[{"code":"741605","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5197.00,"discounted_cash":5197.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2338.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2760.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1711.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4677.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4417.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4157.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1501.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.0 X 26 SH/T ","code_information":[{"code":"25461","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5436.00,"discounted_cash":5436.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2446.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2887.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1790.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4892.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4348.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4348.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4620.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4348.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1571.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.5 44 ","code_information":[{"code":"359582","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":710.00,"discounted_cash":710.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":319.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":377.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":233.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":639.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":568.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":568.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":603.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":568.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":205.19,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.5X30 PT ","code_information":[{"code":"746433","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5532.00,"discounted_cash":5532.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2489.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2938.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1822.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4978.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4702.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1598.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 4.5X48 ","code_information":[{"code":"743361","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5532.00,"discounted_cash":5532.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2489.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2938.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1822.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4978.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4702.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4425.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1598.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X120X16MM ","code_information":[{"code":"171521","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6272.00,"discounted_cash":6272.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2822.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3331.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2066.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5644.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5331.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5017.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1812.61,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 6.5X35X16MM ","code_information":[{"code":"24837","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3 X 65 SHTH ","code_information":[{"code":"173796","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6243.00,"discounted_cash":6243.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2809.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3316.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2056.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5618.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4994.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4994.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5306.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4994.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1804.23,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3X45X32MM ","code_information":[{"code":"353407","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW CANN 7.3X80 408. ","code_information":[{"code":"742924","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EMERG ARCH 2.4X8 ","code_information":[{"code":"174015","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1355.00,"discounted_cash":1355.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":609.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":719.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":446.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1219.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1151.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":391.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EVOS 2.4X18MM ","code_information":[{"code":"380411","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1130.00,"discounted_cash":1130.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":508.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":600.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":372.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1017.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":960.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":904.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":326.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EVOS 2.7X44 CRTX ","code_information":[{"code":"359734","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1149.00,"discounted_cash":1149.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":517.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":610.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":378.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1034.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":919.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":919.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":976.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":919.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":332.06,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EVOS MNI 2X3X32MM ","code_information":[{"code":"359714","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1034.00,"discounted_cash":1034.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":465.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":549.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":340.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":930.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":827.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":827.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":878.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":827.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":298.83,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EVS MNI 2.7X4.5X19 ","code_information":[{"code":"380009","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1190.00,"discounted_cash":1190.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":535.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":632.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":391.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1071.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":952.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":952.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1011.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":952.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":343.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EXFX 130X6-5X30MM ","code_information":[{"code":"24404","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4391.00,"discounted_cash":4391.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":834.29,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":439.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":834.29,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1975.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2332.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1446.40,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1739.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1080.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1080.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1932.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3951.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":979.19,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":6015.67,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":658.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":658.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3732.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2985.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3512.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1317.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2854.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1269.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EXFX 175X4.5X18MM ","code_information":[{"code":"744647","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EXFX 5.2X180X35MM ","code_information":[{"code":"22991","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10569.00,"discounted_cash":10569.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.11,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1056.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1056.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1056.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.11,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4756.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5614.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3481.43,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4187.44,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2599.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2599.97,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4650.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9512.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2356.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8455.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14479.53,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.35,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8455.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8983.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7186.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8455.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3170.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6869.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6869.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6869.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3054.44,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW EXFX 80MM 4MM 3MM ","code_information":[{"code":"356602","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3271.00,"discounted_cash":3271.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":621.49,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":327.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":327.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":327.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":621.49,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1471.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1737.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1077.47,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1295.97,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":804.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":804.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1439.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2943.90,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":729.43,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2616.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4481.27,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":490.65,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":490.65,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2616.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2780.35,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2224.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2616.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":981.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2126.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2126.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2126.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":945.32,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW F-T 5X8X60X3.5MM ","code_information":[{"code":"354657","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4151.00,"discounted_cash":4151.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1867.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2205.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1367.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3735.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3528.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3320.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1199.64,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW F/A S/D 4.5X13 ","code_information":[{"code":"357270","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4064.00,"discounted_cash":4064.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2158.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1338.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3657.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3454.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1174.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW FIXED 4X16MM ","code_information":[{"code":"25422","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6415.00,"discounted_cash":6415.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2886.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3407.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2113.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5773.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5132.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5132.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5452.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5132.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1853.93,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW GD 2.5MM 5MM ","code_information":[{"code":"380164","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3160.00,"discounted_cash":3160.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":600.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":316.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":316.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":316.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":600.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1422.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1678.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1040.90,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1251.99,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":777.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":777.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1390.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2844.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":704.68,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2528.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4329.20,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":474.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":474.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2528.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2686.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2148.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2528.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":948.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2054.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2054.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2054.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":913.24,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HDLS 4.5MMX38MM ","code_information":[{"code":"382827","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HDLS CMPS 3X36MM ","code_information":[{"code":"390370","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HEADLESS 7.0 16MMX ","code_information":[{"code":"384801","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13221.00,"discounted_cash":13221.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5949.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7023.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4355.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11898.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10576.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10576.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11237.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10576.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3820.87,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HEADLESS 7.0MMX50M ","code_information":[{"code":"380917","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19426.00,"discounted_cash":19426.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8741.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10319.09,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6398.92,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17483.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15540.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15540.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16512.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15540.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5614.11,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HEX LOPRO 4.3X36MM ","code_information":[{"code":"357043","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3421.00,"discounted_cash":3421.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1539.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1817.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1126.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3078.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2907.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":988.67,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HFN LAG 10X95MM ","code_information":[{"code":"350391","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7756.00,"discounted_cash":7756.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3490.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4119.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2554.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6980.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6204.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6592.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6204.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2241.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW HXLB HND 2.3X11MM ","code_information":[{"code":"380337","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2538.00,"discounted_cash":2538.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1142.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1348.19,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":836.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2284.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2157.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2030.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":733.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW INT HEX BL 6.4X70 ","code_information":[{"code":"23534","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5833.00,"discounted_cash":5833.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2624.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3098.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1921.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5249.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4666.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4666.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4958.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4666.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1685.74,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW INTFR 9X25 ","code_information":[{"code":"174593","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2709.00,"discounted_cash":2709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1219.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1439.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":892.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2302.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":782.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW INTFR REGENESORB 3 ","code_information":[{"code":"384526","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW INTRFX PEEK 30X9MM ","code_information":[{"code":"918568","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW L/T LOPRO 4X55MM ","code_information":[{"code":"174273","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4704.00,"discounted_cash":4704.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2498.76,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1549.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4233.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3763.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3763.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3998.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3763.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1359.46,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LAG HIP 100X12.7MM ","code_information":[{"code":"741889","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LAG/COMP 70/65 ","code_information":[{"code":"358974","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8413.00,"discounted_cash":8413.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3785.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4468.99,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2771.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7571.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6730.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6730.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7151.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6730.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2431.36,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 0D XL25 5X78MM ","code_information":[{"code":"913244","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5819.00,"discounted_cash":5819.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2618.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3091.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1916.78,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5237.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4946.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4655.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1681.69,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 4.0X18 ","code_information":[{"code":"360144","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3952.00,"discounted_cash":3952.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1778.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2099.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1301.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3556.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3359.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1142.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 4.5X40MM ","code_information":[{"code":"353156","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3034.00,"discounted_cash":3034.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1365.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1611.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":999.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2730.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2427.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2427.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2578.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2427.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":876.83,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK 6.0X26 ","code_information":[{"code":"25496","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK LOPRO 5X76MM ","code_information":[{"code":"425406","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7112.00,"discounted_cash":7112.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3200.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3777.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2342.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6400.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6045.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2055.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK T7 2.7X18 ","code_information":[{"code":"175289","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3005.00,"discounted_cash":3005.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1352.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1596.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":989.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2704.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2404.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2404.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2554.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2404.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":868.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCK TI 3.5X65MM ","code_information":[{"code":"384149","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3538.00,"discounted_cash":3538.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1592.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1879.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1165.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3184.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2830.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2830.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3007.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2830.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1022.48,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCKNG 3.5X16MM ","code_information":[{"code":"381491","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3421.00,"discounted_cash":3421.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1539.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1817.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1126.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3078.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2907.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2736.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":988.67,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LCP LCK 1.5X16MM ","code_information":[{"code":"355590","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2994.00,"discounted_cash":2994.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1347.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1590.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":986.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2694.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2395.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2395.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2544.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2395.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":865.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LMBR SPN VAULT ","code_information":[{"code":"355489","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2709.00,"discounted_cash":2709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1219.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1439.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":892.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2302.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":782.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCK 4MM ST WSTARD ","code_information":[{"code":"174173","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3952.00,"discounted_cash":3952.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1778.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2099.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1301.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3556.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3359.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1142.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCK 5MM 50MM ","code_information":[{"code":"425404","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7112.00,"discounted_cash":7112.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3200.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3777.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2342.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6400.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6045.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5689.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2055.37,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCKING 2.4 X 6MM ","code_information":[{"code":"358888","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2780.00,"discounted_cash":2780.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1251.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1476.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":915.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2502.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2224.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2224.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2363.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2224.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":803.42,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCKING 4.0MM 42MM ","code_information":[{"code":"23399","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3952.00,"discounted_cash":3952.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1778.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2099.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1301.79,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3556.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3359.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3161.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1142.13,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCKING 5.0MMX75MM ","code_information":[{"code":"20226","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5508.00,"discounted_cash":5508.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2478.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2925.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1814.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4957.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4681.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4406.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1591.81,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOCKING 7.3 CANN 7 ","code_information":[{"code":"22010","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOK 3.5X28MM ","code_information":[{"code":"171120","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2430.00,"discounted_cash":2430.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1093.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1290.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":800.44,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2187.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1944.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2065.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1944.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":702.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW LOW PROFILE 3.5 SZ ","code_information":[{"code":"175047","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1279.00,"discounted_cash":1279.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":575.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":679.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":421.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1151.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1023.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1023.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1087.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1023.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":369.63,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MALIBU P-AX 7.5X45 ","code_information":[{"code":"174184","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MICRO 1.2X4 ","code_information":[{"code":"175085","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1340.00,"discounted_cash":1340.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":603.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":711.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":441.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1206.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1072.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1072.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1139.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1072.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":387.26,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MLR 4.5X40 ","code_information":[{"code":"744519","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":874.00,"discounted_cash":874.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":393.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":464.27,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":287.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":786.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":699.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":742.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":699.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":252.59,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MOD BODY HUMERAL ","code_information":[{"code":"382995","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2646.00,"discounted_cash":2646.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1190.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1405.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":871.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2381.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2249.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2116.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":764.69,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MTRX PDCL 7X60MM ","code_information":[{"code":"354684","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9752.00,"discounted_cash":9752.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4388.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5180.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3212.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8776.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7801.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7801.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8289.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7801.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2818.33,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MXLCK MNI 2.4X35MM ","code_information":[{"code":"360163","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3535.00,"discounted_cash":3535.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1590.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1877.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1164.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3181.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2828.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2828.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3004.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2828.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1021.62,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW MXLFCL ST 1.9X3 ","code_information":[{"code":"358015","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1950.00,"discounted_cash":1950.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":877.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1035.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":642.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1755.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1560.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1560.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1657.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1560.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":563.55,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW NCB ZIM 5X40MM ","code_information":[{"code":"351799","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4051.00,"discounted_cash":4051.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1822.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2151.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1334.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3645.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3240.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3240.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3443.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3240.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1170.74,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 3.5X14MM ","code_information":[{"code":"389407","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 4.5X40 ","code_information":[{"code":"171531","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15909.00,"discounted_cash":15909.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7159.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8450.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5240.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14318.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13522.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4597.70,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 5.5X30MM ","code_information":[{"code":"423033","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 5X30MM ","code_information":[{"code":"173576","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 6.5X40MM ","code_information":[{"code":"381380","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12190.00,"discounted_cash":12190.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5485.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6475.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4015.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10971.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10361.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3522.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 6.5X50 ","code_information":[{"code":"171632","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 7.5X35MM ","code_information":[{"code":"357345","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 7X30MM ","code_information":[{"code":"357341","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX 8.5X40MM ","code_information":[{"code":"352121","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN P-AX RED 5.5MM ","code_information":[{"code":"357097","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN PAX 4.5MM 28MM ","code_information":[{"code":"386557","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12190.00,"discounted_cash":12190.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5485.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6475.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4015.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10971.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10361.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3522.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN PDCL 5.5X45MM ","code_information":[{"code":"360297","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14436.00,"discounted_cash":14436.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6496.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7668.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4755.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12992.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12270.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4172.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN PELCN 7.0X40MM ","code_information":[{"code":"355891","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN PLVC 11.5X35MM ","code_information":[{"code":"425272","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":37282.00,"discounted_cash":37282.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16776.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19804.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12280.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33553.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29825.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29825.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31689.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29825.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10774.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN POLY 6.5X45MM ","code_information":[{"code":"354222","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN PYR 10X40 ","code_information":[{"code":"354116","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN RDC 7.5X40MM ","code_information":[{"code":"352122","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN ROMEO 4X45MM ","code_information":[{"code":"357009","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN RVL PLY 7.5X30 ","code_information":[{"code":"351412","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16694.00,"discounted_cash":16694.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7512.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8867.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5499.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4824.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SAV-T 7.5X35MM ","code_information":[{"code":"353358","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SET ","code_information":[{"code":"389405","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1355.00,"discounted_cash":1355.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":609.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":719.78,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":446.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1219.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1151.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1084.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":391.60,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SETX 4X26MM ","code_information":[{"code":"383051","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28871.00,"discounted_cash":28871.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12991.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15336.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9510.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25983.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23096.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23096.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24540.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23096.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8343.72,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SLF TP 4X16 ","code_information":[{"code":"22793","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2709.00,"discounted_cash":2709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1219.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1439.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":892.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2302.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":782.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SLFDRL3.5X19MM ","code_information":[{"code":"916832","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2032.00,"discounted_cash":2032.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1079.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":669.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1727.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":587.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SLFTP 4X14MM ","code_information":[{"code":"359178","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2709.00,"discounted_cash":2709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1219.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1439.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":892.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2302.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2167.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":782.90,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SLFTP 5X45MM ","code_information":[{"code":"25308","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SLFTP 8X45MM ","code_information":[{"code":"171380","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":14141.00,"discounted_cash":14141.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6363.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7511.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4658.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12726.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12019.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11312.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4086.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN SVNAT 6.5X40MM ","code_information":[{"code":"353242","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN TMSH 1.6X4MM ","code_information":[{"code":"355627","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":9084.00,"discounted_cash":9084.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4087.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4825.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2992.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8175.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7267.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7267.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7721.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7267.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2625.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN VA HEX 4.5X20 ","code_information":[{"code":"918784","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4064.00,"discounted_cash":4064.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2158.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1338.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3657.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3454.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1174.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN VAR 4.5X14MM ","code_information":[{"code":"387132","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2032.00,"discounted_cash":2032.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1079.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":669.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1727.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":587.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN VAR ANG 3.7X14 ","code_information":[{"code":"352279","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPN VRTX 3.5X14MM ","code_information":[{"code":"356761","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNE 30X5.5 CHSPK ","code_information":[{"code":"357229","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4064.00,"discounted_cash":4064.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2158.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1338.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3657.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3454.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3251.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1174.50,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 3.5X16MM ","code_information":[{"code":"430816","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12190.00,"discounted_cash":12190.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5485.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6475.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4015.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10971.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10361.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9752.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3522.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 4MM 24MM ","code_information":[{"code":"380696","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 5.5MM 35MM ","code_information":[{"code":"384829","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 6.5MM 35MM ","code_information":[{"code":"358696","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15221.00,"discounted_cash":15221.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6849.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8085.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5013.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13698.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12176.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12176.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12937.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12176.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4398.87,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 6.5MM 45MM ","code_information":[{"code":"919057","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6095.00,"discounted_cash":6095.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2742.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3237.66,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2007.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5485.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4876.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4876.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5180.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4876.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1761.45,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 6X55MM CFX TI ","code_information":[{"code":"357297","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":19640.00,"discounted_cash":19640.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8838.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10432.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6469.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":16694.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":15712.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5675.96,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL 7.5MM 50MM ","code_information":[{"code":"359693","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17676.00,"discounted_cash":17676.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7954.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9389.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5822.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15908.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5108.36,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL DBL LD 4.5X16 ","code_information":[{"code":"383217","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2032.00,"discounted_cash":2032.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":914.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1079.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":669.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1727.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1625.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":587.25,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL RDC 4.5X35MM ","code_information":[{"code":"385842","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12544.00,"discounted_cash":12544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5644.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6663.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4131.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11289.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10035.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10035.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10662.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10035.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3625.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SPNL V-A 4X16MM ","code_information":[{"code":"352668","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4741.00,"discounted_cash":4741.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2133.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2518.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1561.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4266.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4029.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3792.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1370.15,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SS S/T 4X38MM ","code_information":[{"code":"351401","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2705.00,"discounted_cash":2705.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1217.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1436.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":891.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2434.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2164.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2164.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2299.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2164.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":781.75,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW ST HND 2.4X13X4MM ","code_information":[{"code":"354921","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW STP THRD 2.7X18MM ","code_information":[{"code":"350342","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2235.00,"discounted_cash":2235.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1005.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1187.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":736.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2011.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1788.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1788.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1899.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1788.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":645.91,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SYN 5.0MMX35MM ","code_information":[{"code":"23129","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW SYS CNQST 1L PDCL ","code_information":[{"code":"174862","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":214583.00,"discounted_cash":214583.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":96562.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":113986.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":70683.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":193124.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":171666.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":171666.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":182395.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":171666.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":62014.49,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW T25 LCK ANG 5X38MM ","code_information":[{"code":"388558","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3632.00,"discounted_cash":3632.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1634.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1929.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1196.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3268.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3087.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1049.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW THEKEN 4.5X13 ","code_information":[{"code":"22586","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4703.00,"discounted_cash":4703.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2116.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2498.23,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1549.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4232.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3762.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3762.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3997.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3762.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1359.17,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI 4MM X 42MM ","code_information":[{"code":"171658","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4071.00,"discounted_cash":4071.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1831.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2162.52,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1340.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3663.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3460.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3256.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1176.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI ASLS 4X30MM LCK ","code_information":[{"code":"389219","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3632.00,"discounted_cash":3632.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1634.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1929.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1196.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3268.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3087.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2905.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1049.65,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI CANN 7.3X105 ","code_information":[{"code":"20359","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI CANN 7.3X55 ","code_information":[{"code":"20350","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI CORT 1.0X10 ","code_information":[{"code":"357534","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2012.00,"discounted_cash":2012.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":905.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1068.77,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":662.75,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1810.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1609.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1609.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1710.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1609.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":581.47,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI CORT 2.7X20 ","code_information":[{"code":"380427","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":898.00,"discounted_cash":898.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":404.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":477.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":295.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":808.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":763.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":718.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":259.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI LOCKING 6.0X85M ","code_information":[{"code":"20400","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4450.00,"discounted_cash":4450.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2002.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2363.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1465.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4005.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3560.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3560.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3782.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3560.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1286.05,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TI VECTRA 4.0 X 16 ","code_information":[{"code":"175018","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TNODSIS CMPR 8X12 ","code_information":[{"code":"383322","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7129.00,"discounted_cash":7129.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3208.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3786.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2348.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6416.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6059.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5703.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2060.28,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TRGN HUM 4X38MM ","code_information":[{"code":"351934","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2771.00,"discounted_cash":2771.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1246.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1471.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":912.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2493.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2216.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2216.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2355.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2216.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":800.82,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TRIMED 2.3X26 ","code_information":[{"code":"23784","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1853.00,"discounted_cash":1853.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":833.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":984.31,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":610.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1667.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1482.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1482.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1575.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1482.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":535.52,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW TT LCK SELFDRILL 5 ","code_information":[{"code":"26089","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5915.00,"discounted_cash":5915.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2661.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3142.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1948.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5323.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4732.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4732.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5027.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4732.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1709.43,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX ELB 2.7X12MM ","code_information":[{"code":"355434","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4700.00,"discounted_cash":4700.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2115.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2496.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1548.18,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4230.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3760.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3760.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3995.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3760.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1358.30,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX FT LCK 3.5X30 ","code_information":[{"code":"355939","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":3969.00,"discounted_cash":3969.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1786.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2108.33,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1307.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3572.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3175.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3175.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3373.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3175.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1147.04,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX NLCK 3.5X14 ","code_information":[{"code":"355563","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1827.00,"discounted_cash":1827.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":822.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":970.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":601.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1644.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1552.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":528.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX NLCK 3.5X36 ","code_information":[{"code":"355933","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1827.00,"discounted_cash":1827.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":822.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":970.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":601.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1644.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1552.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1461.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":528.00,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX ORTH 3.5X14MM ","code_information":[{"code":"173153","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1542.00,"discounted_cash":1542.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":693.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":819.11,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":507.93,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1387.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1233.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1233.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1310.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1233.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":445.64,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW V-AX RADL 2.3X22 ","code_information":[{"code":"350693","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2603.00,"discounted_cash":2603.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1171.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1382.71,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":857.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2342.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2082.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2082.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2212.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2082.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":752.27,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW VA-SD HYBRD 4X12MM ","code_information":[{"code":"173135","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW VIRAGE 3.5X14MM PO ","code_information":[{"code":"358706","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCREW WM 3.5MMX14MM ","code_information":[{"code":"23105","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2424.00,"discounted_cash":2424.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1090.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1287.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":798.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2060.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1939.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":700.54,"methodology":"percent of total billed charges"}]}]},{"description":"SCREWDRVR OSTEO 2BTR-PWR ","code_information":[{"code":"356870","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6130.00,"discounted_cash":6130.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1164.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":613.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":613.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":613.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1164.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2758.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3256.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2019.22,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2428.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1507.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1507.98,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2697.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5517.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1366.99,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4904.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":8398.10,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":919.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":919.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4904.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5210.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4168.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4904.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1839.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3984.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3984.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":3984.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1771.57,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW BN 4.5X25MM DYNTA ","code_information":[{"code":"390027","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13544.00,"discounted_cash":13544.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6094.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7194.57,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4461.39,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12189.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11512.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10835.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3914.22,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW BNE 45MM ","code_information":[{"code":"744333","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2438.00,"discounted_cash":2438.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1097.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1295.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":803.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2194.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2072.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1950.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":704.58,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW BNE SPNL 3.5X12MM ","code_information":[{"code":"26514","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13547.00,"discounted_cash":13547.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6096.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7196.17,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4462.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12192.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11514.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10837.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3915.08,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW CANNUL  6.5 X 22X75 ","code_information":[{"code":"743497","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4706.00,"discounted_cash":4706.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2117.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2499.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1550.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4235.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4000.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3764.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1360.03,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW CORTEX ST 4.0X24MM ","code_information":[{"code":"24682","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":719.00,"discounted_cash":719.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":323.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":381.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":236.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":647.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":575.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":575.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":611.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":575.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":207.79,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW IAME POLY  7 X 35 ","code_information":[{"code":"21110","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SCRW SPNE 4.5MM 16MM ","code_information":[{"code":"383065","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5418.00,"discounted_cash":5418.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2438.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2878.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1784.69,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4876.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4605.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4334.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1565.80,"methodology":"percent of total billed charges"}]}]},{"description":"SEAL CAP RETRACTOR 9.5CM ","code_information":[{"code":"391267","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":20487.00,"discounted_cash":20487.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3892.53,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2048.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2048.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2048.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":3892.53,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9219.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":10882.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":6748.42,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8116.95,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5039.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5039.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9014.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":18438.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4568.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":28067.19,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3073.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3073.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":17413.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":13931.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16389.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6146.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13316.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13316.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":13316.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5920.74,"methodology":"percent of total billed charges"}]}]},{"description":"SEALER BIP 20CM 13MM ","code_information":[{"code":"385437","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":11717.00,"discounted_cash":11717.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2226.23,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1171.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1171.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1171.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2226.23,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5272.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6224.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3859.58,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4642.28,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2882.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2882.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":5155.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10545.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2612.89,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9373.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":16052.29,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1757.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1757.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9373.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":9959.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7967.56,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9373.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3515.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7616.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7616.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7616.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3386.21,"methodology":"percent of total billed charges"}]}]},{"description":"SEALER TISS STR X1 37CM ","code_information":[{"code":"391306","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14485.01,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6872.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"SECRETIN SYN HUMAN 1 MCG ","drug_information":{"unit":"1","type":"GM"},"code_information":[{"code":"126995","type":"CDM"},{"code":"J2850","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":395.25,"discounted_cash":395.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":177.86,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":173.91,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":355.73,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":316.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":59.29,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":316.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":335.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":316.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":114.23,"methodology":"percent of total billed charges"}]}]},{"description":"SEIZURES WITHOUT MCC ","code_information":[{"code":"101","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":17579.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":11460.65,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":13868.68,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":9355.63,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":11928.43,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":17403.21,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":8186.18,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":17579.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":16489.30,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":11460.65,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":12279.27,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":11694.54,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":17579.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":17579.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":11694.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":8186.18,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":8186.18,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":8186.18,"methodology":"fee schedule"}]}]},{"description":"SEMEN ANALYSIS MOT & CT ","code_information":[{"code":"362180","type":"CDM"},{"code":"89310","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":532.25,"discounted_cash":532.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":101.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":101.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":239.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":234.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":479.02,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":118.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":79.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":452.41,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":361.93,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":153.82,"methodology":"percent of total billed charges"}]}]},{"description":"SENSRY INTEGRTN 15M OTCO ","code_information":[{"code":"766018","type":"CDM"},{"code":"97533","type":"CPT"}],"standard_charges":[{"modifiers":"GO|CO","modifiers_description":"Services delivered under an outpatient occupational therapy plan of care|Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant","setting":"outpatient","gross_charge":248.50,"discounted_cash":248.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":47.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":47.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":111.83,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":98.46,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":109.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":223.65,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":55.42,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":37.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":211.22,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":168.98,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":198.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":71.82,"methodology":"percent of total billed charges"}]}]},{"description":"SEPTIC ARTHRITIS WITH CC ","code_information":[{"code":"549","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":23312.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":14717.68,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":18640.79,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":12014.43,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":15318.40,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":23078.88,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":10512.63,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":23312.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":21175.44,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":14717.68,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":15768.94,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":15018.04,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 3. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":23312.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":23312.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":15018.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":10512.63,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":10512.63,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":10512.63,"methodology":"fee schedule"}]}]},{"description":"SERTRALINE 100MG TAB ","code_information":[{"code":"120959","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":43.25,"discounted_cash":43.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":8.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":8.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":22.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":14.25,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":17.14,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":19.03,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":38.92,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":9.64,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":59.25,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.49,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6.49,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36.76,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":29.41,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":12.97,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28.11,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28.11,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28.11,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12.50,"methodology":"percent of total billed charges"}]}]},{"description":"SET ADM 104IN 60 GTT 17M ","code_information":[{"code":"387884","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":139.00,"discounted_cash":139.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":26.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":26.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":62.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":73.84,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":45.79,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":55.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":34.19,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":34.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":61.16,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":125.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":31.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":111.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":190.43,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":20.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":20.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":111.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":118.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":94.52,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":111.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":41.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":90.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":90.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":90.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":40.17,"methodology":"percent of total billed charges"}]}]},{"description":"SET BX 20GA 9CM ","code_information":[{"code":"387527","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3237.00,"discounted_cash":3237.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":615.03,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":323.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":323.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":323.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":615.03,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1456.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1719.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1066.27,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1282.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":796.30,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":796.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1424.28,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2913.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":721.85,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2589.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4434.69,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":485.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":485.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2589.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2751.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2201.16,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2589.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":971.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2104.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2104.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2104.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":935.49,"methodology":"percent of total billed charges"}]}]},{"description":"SET CPX BRDG CRDPLG 4:1 ","code_information":[{"code":"357939","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET DRN LINE LCK ","code_information":[{"code":"360929","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1158.00,"discounted_cash":1158.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":220.02,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":115.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":115.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":115.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":220.02,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":521.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":615.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":381.45,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":458.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":284.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":284.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":509.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1042.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":258.23,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":926.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1586.46,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":173.70,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":173.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":926.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":984.30,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":787.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":926.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":347.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":752.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":334.66,"methodology":"percent of total billed charges"}]}]},{"description":"SET HYSCP SEAL OFLW ","code_information":[{"code":"387031","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":757.00,"discounted_cash":757.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":143.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":75.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":75.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":75.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":143.83,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":340.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":402.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":249.36,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":299.92,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":186.22,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":186.22,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":333.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":681.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":168.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":605.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1037.09,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":113.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":113.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":643.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":514.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":605.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":227.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":492.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":492.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":492.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":218.77,"methodology":"percent of total billed charges"}]}]},{"description":"SET CARDPLGA DELV SYS ","code_information":[{"code":"913300","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET DILATOR SHTH 24-30FR ","code_information":[{"code":"918663","type":"CDM"},{"code":"C1894","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7322.00,"discounted_cash":7322.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1391.18,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1391.18,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3294.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3889.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2411.87,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2900.98,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1801.21,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1801.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3221.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6589.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1632.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5857.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1098.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5857.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6223.70,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4978.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5857.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2196.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2116.06,"methodology":"percent of total billed charges"}]}]},{"description":"SET ENDO INST HIP GW NDL ","code_information":[{"code":"426408","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":8904.00,"discounted_cash":8904.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1691.76,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":890.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":890.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":890.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1691.76,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4006.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4729.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2932.98,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3527.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2190.38,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2190.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3917.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":8013.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1985.59,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7123.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":12198.48,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1335.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1335.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7123.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7568.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":6054.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7123.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2671.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5787.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5787.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5787.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2573.26,"methodology":"percent of total billed charges"}]}]},{"description":"SET INCS FSCA 18GA 5CM ","code_information":[{"code":"390776","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2729.00,"discounted_cash":2729.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":518.51,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":272.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":272.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":272.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":518.51,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1228.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1449.64,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":898.93,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1081.23,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":671.33,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":671.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1200.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2456.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":608.57,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2183.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3738.73,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":409.35,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":409.35,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2183.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2319.65,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1855.72,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2183.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":818.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1773.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1773.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1773.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":788.68,"methodology":"percent of total billed charges"}]}]},{"description":"SET INTRO SHTH 6FR 45CM ","code_information":[{"code":"468684","type":"CDM"},{"code":"C1894","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET IRR TBNG CORD DISP ","code_information":[{"code":"389931","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2286.00,"discounted_cash":2286.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":434.34,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":228.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":434.34,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1028.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1214.32,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":753.01,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":905.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":562.36,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":562.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1005.84,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2057.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":509.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3131.82,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":342.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":342.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1943.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1554.48,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1828.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":685.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1485.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1485.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1485.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":660.65,"methodology":"percent of total billed charges"}]}]},{"description":"SET PEG SFTY PSH 20FR ","code_information":[{"code":"382250","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET SCREW BN PF 8MM ","code_information":[{"code":"390211","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":5158.00,"discounted_cash":5158.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2321.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2739.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1699.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4642.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4126.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4126.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4384.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4126.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1490.66,"methodology":"percent of total billed charges"}]}]},{"description":"SET SHTH URT 11-13F 36CM ","code_information":[{"code":"182305","type":"CDM"},{"code":"C1894","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET SPN CTTNMTH 18MM 6D ","code_information":[{"code":"350514","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":58920.00,"discounted_cash":58920.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5892.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5892.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5892.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":26514.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":31298.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":19408.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":53028.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47136.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":80720.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47136.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":50082.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":47136.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":38298.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":38298.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":38298.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":17027.88,"methodology":"percent of total billed charges"}]}]},{"description":"SET SPRAY COSEAL SEALANT ","code_information":[{"code":"182803","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3045.00,"discounted_cash":3045.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":578.55,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":304.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":304.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":304.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":578.55,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1370.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1617.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1003.02,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1206.43,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":749.07,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":749.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1339.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2740.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":679.03,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2436.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":4171.65,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":456.75,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":456.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2436.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2588.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2070.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2436.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":913.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1979.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1979.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1979.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":880.00,"methodology":"percent of total billed charges"}]}]},{"description":"SET VENTR DRN TBG ","code_information":[{"code":"182754","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":4219.00,"discounted_cash":4219.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":421.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":801.61,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1898.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":2241.13,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1389.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1671.57,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1037.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1856.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3797.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":940.84,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5780.03,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":632.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3586.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2868.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3375.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1265.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2742.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1219.29,"methodology":"percent of total billed charges"}]}]},{"description":"SET XTN STD 6IN IV BOR ","code_information":[{"code":"353283","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":113.00,"discounted_cash":113.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11.30,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":21.47,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":50.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":60.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":37.22,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":44.77,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":27.80,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":27.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":49.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":101.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":154.81,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":16.95,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":16.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":96.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":76.84,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":33.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73.45,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73.45,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":32.66,"methodology":"percent of total billed charges"}]}]},{"description":"SGD INCL PROGRAM/MOD SP ","code_information":[{"code":"590064","type":"CDM"},{"code":"92609","type":"CPT"}],"standard_charges":[{"modifiers":"GN","modifiers_description":"Services delivered under an outpatient speech language pathology plan of care","setting":"outpatient","gross_charge":994.50,"discounted_cash":994.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":188.96,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":188.96,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":447.52,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":394.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":437.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":895.05,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":221.77,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":149.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":845.33,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":676.26,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":795.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":287.41,"methodology":"percent of total billed charges"}]}]},{"description":"SHAVER BURR RND FLTD 5.0 ","code_information":[{"code":"385566","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":3708.00,"discounted_cash":3708.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":704.52,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":370.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":370.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":370.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":704.52,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1668.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1969.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1221.42,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":1469.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":912.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":912.17,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1631.52,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3337.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":826.88,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2966.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":5079.96,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":556.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":556.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2966.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3151.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2521.44,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2966.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1112.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2410.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2410.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":2410.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1071.61,"methodology":"percent of total billed charges"}]}]},{"description":"SHEARS ESURG CRV 45X5 ","code_information":[{"code":"357940","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":6648.00,"discounted_cash":6648.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1263.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":664.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":664.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":664.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1263.12,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2991.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3531.42,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2189.85,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":2633.94,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1635.41,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1635.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2925.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5983.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1482.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5318.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":9107.76,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":997.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":997.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5318.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5650.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4520.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5318.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1994.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4321.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4321.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":4321.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1921.27,"methodology":"percent of total billed charges"}]}]},{"description":"SILVER NITRATE AP 100 ","code_information":[{"code":"126329","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":212.50,"discounted_cash":212.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":40.38,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":21.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":21.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":21.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":40.38,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":95.63,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":112.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":70.00,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":52.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":93.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":191.25,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":47.39,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":170.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":291.13,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":31.88,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":31.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":170.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":180.63,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":144.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":170.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":63.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":138.13,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":138.13,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":138.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":61.41,"methodology":"percent of total billed charges"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC ","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":12090.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":8026.63,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":9873.45,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":6552.35,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":8354.25,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":11969.10,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":5733.31,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":12090.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":11548.52,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":8026.63,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":8599.96,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":8190.44,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 2. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":12090.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":12090.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":8190.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":8530.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":5733.31,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":5733.31,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":5733.31,"methodology":"fee schedule"}]}]},{"description":"SINEMET CR 50/200 TAB ","code_information":[{"code":"120933","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":27.50,"discounted_cash":27.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2.75,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":5.22,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9.06,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":10.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.76,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":6.76,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12.10,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":24.75,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":6.13,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":37.67,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.13,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.13,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23.38,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":18.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":8.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17.88,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.95,"methodology":"percent of total billed charges"}]}]},{"description":"SIROLIMUS 1 MG PO ","drug_information":{"unit":"1","type":"ME"},"code_information":[{"code":"127446","type":"CDM"},{"code":"J7520","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":113.25,"discounted_cash":113.25,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":50.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":49.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":101.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":16.99,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":96.26,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":90.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":32.73,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BREAST 200CC ","code_information":[{"code":"184544","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2230.00,"discounted_cash":2230.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":423.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":223.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":223.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":223.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":423.70,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1003.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1184.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":734.56,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":883.53,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":548.58,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":548.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":981.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2007.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":497.29,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":3055.10,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":334.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":334.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1895.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1516.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1784.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":669.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1449.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1449.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1449.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":644.47,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BREAST 450CC ","code_information":[{"code":"350224","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1466.00,"discounted_cash":1466.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":659.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":778.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":482.90,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":580.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":645.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1319.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":326.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2008.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1246.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":996.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":439.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":423.67,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BREAST 650CC ","code_information":[{"code":"354616","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1466.00,"discounted_cash":1466.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":659.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":778.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":482.90,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":580.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":645.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1319.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":326.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2008.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1246.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":996.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":439.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":423.67,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BRST 275-330MLPRFL ","code_information":[{"code":"356320","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":1466.00,"discounted_cash":1466.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":146.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":278.54,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":659.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":778.74,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":482.90,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":580.83,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":360.64,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":645.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1319.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":326.92,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2008.42,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":219.90,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1246.10,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":996.88,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1172.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":439.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":952.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":423.67,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BRST 450-475 ","code_information":[{"code":"381442","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2007.00,"discounted_cash":2007.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":903.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1066.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":661.11,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":795.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":883.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1806.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":447.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2749.59,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":602.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER BRST GEL 425-430ML ","code_information":[{"code":"387649","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2007.00,"discounted_cash":2007.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":903.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1066.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":661.11,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":795.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":883.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1806.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":447.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2749.59,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":602.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER IMPLANT MAMMARY 27 ","code_information":[{"code":"381318","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2007.00,"discounted_cash":2007.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":200.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":381.33,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":903.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1066.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":661.11,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":795.17,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":493.72,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":883.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1806.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":447.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2749.59,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":301.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1705.95,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1364.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1605.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":602.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1304.55,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":580.02,"methodology":"percent of total billed charges"}]}]},{"description":"SIZER STAPLE ORTH ","code_information":[{"code":"386499","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":7990.00,"discounted_cash":7990.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1518.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":799.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":799.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":799.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1518.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3595.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4244.29,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2631.91,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":3165.64,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1965.54,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":1965.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":3515.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7191.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1781.77,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6392.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":10946.30,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1198.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1198.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6392.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6791.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":5433.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6392.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":2397.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5193.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5193.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":5193.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2309.11,"methodology":"percent of total billed charges"}]}]},{"description":"SKIN DEBRIDEMENT WITH CC ","code_information":[{"code":"571","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":32699.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":20116.95,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":23172.72,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":16422.00,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":20938.05,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":32372.01,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":14369.25,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":32699.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":28943.77,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":20116.95,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":21553.88,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":20527.50,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":32699.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":32699.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":20527.50,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":14369.25,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":14369.25,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":14369.25,"methodology":"fee schedule"}]}]},{"description":"SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ","code_information":[{"code":"575","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","minimum":1183.00,"maximum":39542.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Alignment Health Plan","plan_name":"MGMCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"American Health System","plan_name":"HIX","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":"Anthem ","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Brand New Day","plan_name":"MCR","standard_charge_dollar":23814.15,"methodology":"fee schedule"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_dollar":28809.18,"methodology":"case rate"},{"payer_name":"Bristol Hospice","plan_name":"MGMCR","standard_charge_dollar":19440.12,"methodology":"fee schedule"},{"payer_name":"Care1st Health Plan","plan_name":"MCR","standard_charge_dollar":24786.15,"methodology":"fee schedule"},{"payer_name":"Central Health Plan","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"CorVel Corporation ","plan_name":"WORKERSCOMP","standard_charge_dollar":39146.58,"methodology":"fee schedule"},{"payer_name":"Destiny Hospice Care","plan_name":"COMM","standard_charge_dollar":17010.10,"methodology":"fee schedule"},{"payer_name":"Easy Choice Health Plan","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Emerging Therapy Solutions","plan_name":"Commercial","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":"First Health ","plan_name":"COMM","standard_charge_dollar":3407.00,"methodology":"per diem"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","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":"HealthSmart","plan_name":"WorkersComp","standard_charge_dollar":39542.00,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_dollar":34263.21,"methodology":"fee schedule"},{"payer_name":"Heritage Provider Network","plan_name":"MGMCR","standard_charge_dollar":23814.15,"methodology":"fee schedule"},{"payer_name":"Humana ","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_dollar":25515.16,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_dollar":24300.15,"methodology":"fee schedule","additional_payer_notes":"Days 1 - 4. "},{"payer_name":"Medi-Cal ","plan_name":"MCR","standard_charge_dollar":1363.00,"methodology":"per diem"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","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":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":82.00,"standard_charge_algorithm":"Reimbursement will be 82% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"WCOMP","standard_charge_dollar":39542.00,"methodology":"fee schedule"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_dollar":1183.00,"methodology":"per diem"},{"payer_name":"Next","plan_name":"WCOMP","standard_charge_dollar":39542.00,"methodology":"fee schedule"},{"payer_name":"Optum Transplants OON ","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Redlands Community Hospital ","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"Scan Health Plan","plan_name":"MCR","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"TriWest Healthcare Alliance","plan_name":"Veterans","standard_charge_dollar":24300.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"AllPayerAppendix","standard_charge_dollar":15798.00,"methodology":"case rate","additional_payer_notes":"Days 1 - 2.  If billable gross charges exceed threshold of $462018.00, reimbursement will be $13783 per diem instead of the contracted rate."},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.70,"standard_charge_algorithm":"Reimbursement will be 28.7% of billable gross charges.","estimated_amount":999999999.00,"methodology":"percent of total billed charges"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"COMM","standard_charge_dollar":17010.10,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCD","standard_charge_dollar":17010.10,"methodology":"fee schedule"},{"payer_name":"Vitas Healthcare Hospice","plan_name":"MCR","standard_charge_dollar":17010.10,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB FDA DEVICE NOC ","code_information":[{"code":"390541","type":"CDM"},{"code":"A4100","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25.00,"discounted_cash":25.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":11.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7.22,"methodology":"percent of total billed charges"}]}]},{"description":"SKIN SUB FDA DEVICE NOC ","code_information":[{"code":"412856","type":"CDM"},{"code":"A4100","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28.00,"discounted_cash":28.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12.60,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":12.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":4.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8.09,"methodology":"percent of total billed charges"}]}]},{"description":"SKIN SUBSTITUTE NOS ","code_information":[{"code":"387684","type":"CDM"},{"code":"Q4100","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":670.00,"discounted_cash":670.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":301.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":294.80,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":603.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":536.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":100.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":536.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":569.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":536.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":193.63,"methodology":"percent of total billed charges"}]}]},{"description":"SLED IVUS PULBCK GLXY ","code_information":[{"code":"24017","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":2185.00,"discounted_cash":2185.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":415.15,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":218.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":218.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":218.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":415.15,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":983.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1160.67,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":719.74,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":865.70,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":537.51,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":537.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":961.40,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1966.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":487.25,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1748.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":2993.45,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":327.75,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":327.75,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1748.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1857.25,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":1485.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1748.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":655.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1420.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1420.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":1420.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":631.47,"methodology":"percent of total billed charges"}]}]},{"description":"SLEEVE CNTRNG HIP SM 18B ","code_information":[{"code":"357179","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":7525.00,"discounted_cash":7525.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3386.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3997.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2478.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":6772.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":6396.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":6020.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2174.72,"methodology":"percent of total billed charges"}]}]},{"description":"SLEEVE HIP LONG ","code_information":[{"code":"387893","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6622.00,"discounted_cash":6622.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2979.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3517.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2181.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5959.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5297.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5297.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5628.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5297.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1913.76,"methodology":"percent of total billed charges"}]}]},{"description":"SLEEVE LPSCP RPRC 5X100 ","code_information":[{"code":"355841","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":372.00,"discounted_cash":372.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":70.68,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":37.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":37.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":37.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":70.68,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":167.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":197.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":122.54,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":147.39,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":91.51,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":91.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":163.68,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":334.80,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":82.96,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":297.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":509.64,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":55.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":55.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":297.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":316.20,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":252.96,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":297.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":111.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":241.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":241.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":241.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":107.51,"methodology":"percent of total billed charges"}]}]},{"description":"SLEEVE TIB KN PRCT 37MM ","code_information":[{"code":"918122","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28032.00,"discounted_cash":28032.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12614.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14890.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9233.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25228.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22425.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23827.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22425.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8101.25,"methodology":"percent of total billed charges"}]}]},{"description":"SLING URETH MESH ALGN HK ","code_information":[{"code":"171087","type":"CDM"},{"code":"C1771","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":11899.00,"discounted_cash":11899.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5354.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6320.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3919.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10709.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9519.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10114.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9519.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3438.81,"methodology":"percent of total billed charges"}]}]},{"description":"SLR/DVDR LAPSCP 37CM ","code_information":[{"code":"21930","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":10575.00,"discounted_cash":10575.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2009.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1057.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2009.25,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4758.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5617.44,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3483.41,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2601.45,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2601.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4653.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9517.50,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2358.22,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8460.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":14487.75,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1586.25,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1586.25,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8460.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8988.75,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7191.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8460.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3172.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6873.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6873.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":6873.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3056.18,"methodology":"percent of total billed charges"}]}]},{"description":"SMEAR EOSINOPHILS STAIN ","code_information":[{"code":"362540","type":"CDM"},{"code":"87205","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":532.25,"discounted_cash":532.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":101.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":101.13,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":239.51,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":234.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":479.02,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":118.69,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":79.84,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":452.41,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":361.93,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":425.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":153.82,"methodology":"percent of total billed charges"}]}]},{"description":"SMOOTH MUSC FA AB QL ","code_information":[{"code":"371530","type":"CDM"},{"code":"86015","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":5.29,"discounted_cash":5.29,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1.01,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2.38,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":4.76,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1.18,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4.23,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":0.79,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4.23,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":4.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":3.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4.23,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1.53,"methodology":"percent of total billed charges"}]}]},{"description":"SNARE ESCPC 7F 27-45X120 ","code_information":[{"code":"468923","type":"CDM"},{"code":"C1773","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10573.00,"discounted_cash":10573.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2008.87,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4757.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5616.38,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3482.75,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":4189.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":2600.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":4652.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9515.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":2357.78,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":1585.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8987.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":7189.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8458.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":3171.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3055.60,"methodology":"percent of total billed charges"}]}]},{"description":"SNARE RND 2.8MM 240MM ","code_information":[{"code":"390395","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":859.00,"discounted_cash":859.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":85.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":163.21,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":386.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":456.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":282.95,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":340.34,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":211.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":377.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":773.10,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":191.56,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1176.83,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":128.85,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":730.15,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":584.12,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":687.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":257.70,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":558.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":248.25,"methodology":"percent of total billed charges"}]}]},{"description":"SNARE VASC 69IN .28IN ","code_information":[{"code":"386843","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15244.00,"discounted_cash":15244.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1524.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2896.36,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6859.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8097.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5021.37,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":6039.67,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":3750.02,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6707.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13719.60,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3399.41,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":20884.28,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2286.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2286.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12957.40,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10365.92,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12195.20,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4573.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9908.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4405.52,"methodology":"percent of total billed charges"}]}]},{"description":"SOD BICARB 4.2% 5ML SDV ","code_information":[{"code":"126203","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":48.00,"discounted_cash":48.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.12,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":9.12,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":25.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":11.81,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":11.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":21.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":43.20,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":10.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":65.76,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.20,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":7.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":40.80,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":32.64,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":38.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":14.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13.87,"methodology":"percent of total billed charges"}]}]},{"description":"SOD CITRATE 4% SOL 500ML ","code_information":[{"code":"125296","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":157.00,"discounted_cash":157.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":29.83,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":15.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":15.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":15.70,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":29.83,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":70.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":83.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":51.72,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":38.62,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":38.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":69.08,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":141.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":35.01,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":125.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":215.09,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":23.55,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":23.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":125.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":133.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":106.76,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":125.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":47.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":102.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":102.05,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":102.05,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":45.37,"methodology":"percent of total billed charges"}]}]},{"description":"SODIUM BLD ","code_information":[{"code":"364060","type":"CDM"},{"code":"84295","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":328.50,"discounted_cash":328.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":62.41,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":62.41,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":147.82,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":144.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":295.65,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":73.26,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":49.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":279.23,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":223.38,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":262.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":94.94,"methodology":"percent of total billed charges"}]}]},{"description":"SODIUM THIOSULFATE ","code_information":[{"code":"126443","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":369.50,"discounted_cash":369.50,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":70.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":36.95,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":70.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":166.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":196.28,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":121.71,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":90.90,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":90.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":162.58,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":332.55,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":82.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":295.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":506.21,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":55.42,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":55.42,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":295.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":314.07,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":251.26,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":295.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":110.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":240.18,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":240.18,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":240.18,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":106.79,"methodology":"percent of total billed charges"}]}]},{"description":"SOLUTION IRR NACL 1000ML ","code_information":[{"code":"382284","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":250.00,"discounted_cash":250.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":47.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":25.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":25.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":25.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":47.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":112.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":132.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":82.35,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":99.05,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":61.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":61.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":110.00,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":225.00,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":55.75,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":200.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":342.50,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":37.50,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":37.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":200.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":212.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":170.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":200.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":75.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":162.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":162.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":162.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":72.25,"methodology":"percent of total billed charges"}]}]},{"description":"SOTRADECOL 3% INJ ","code_information":[{"code":"127956","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":801.25,"discounted_cash":801.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":152.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":80.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":80.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":80.13,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":152.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":360.56,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":425.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":263.93,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":197.11,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":197.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":352.55,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":721.13,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":178.68,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":641.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":1097.71,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":120.19,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":120.19,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":641.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":681.06,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":544.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":641.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":240.38,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":520.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":520.81,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":520.81,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":231.56,"methodology":"percent of total billed charges"}]}]},{"description":"SP ANGIO ADREN SEL BI ","code_information":[{"code":"275733","type":"CDM"},{"code":"75733","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":14896.00,"discounted_cash":14896.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2830.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2830.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6703.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6554.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13406.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3321.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2234.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12661.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10129.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4468.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4304.94,"methodology":"percent of total billed charges"}]}]},{"description":"SP ANGIO PELVIC ","code_information":[{"code":"277135","type":"CDM"},{"code":"75736","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":14896.00,"discounted_cash":14896.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2830.24,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":2830.24,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6703.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":6554.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13406.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":3321.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":2234.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12661.60,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":10129.28,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11916.80,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":4468.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4304.94,"methodology":"percent of total billed charges"}]}]},{"description":"SP ANGIO SPINAL SELECT ","code_information":[{"code":"275705","type":"CDM"},{"code":"75705","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":6259.25,"discounted_cash":6259.25,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1189.26,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1189.26,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2816.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2754.07,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5633.32,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1395.81,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5007.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":938.89,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5007.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5320.36,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4256.29,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5007.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1877.78,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1808.92,"methodology":"percent of total billed charges"}]}]},{"description":"SP AORTOGM TH W/FILM ","code_information":[{"code":"465610","type":"CDM"},{"code":"75605","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":21177.00,"discounted_cash":21177.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4023.63,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":4023.63,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9529.65,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9317.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19059.30,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4722.47,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16941.60,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3176.55,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16941.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18000.45,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":14400.36,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":16941.60,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":6353.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6120.15,"methodology":"percent of total billed charges"}]}]},{"description":"SP EX CAROTID ANGIO UNIL ","code_information":[{"code":"276222","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21816.00,"discounted_cash":21816.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9817.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8643.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9599.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19634.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4864.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29887.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18543.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6304.82,"methodology":"percent of total billed charges"}]}]},{"description":"SP INCRAN ANGIO ","code_information":[{"code":"466228","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21816.00,"discounted_cash":21816.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9817.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8643.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9599.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19634.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4864.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29887.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18543.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6304.82,"methodology":"percent of total billed charges"}]}]},{"description":"SP PERC DRAIN ","code_information":[{"code":"277181","type":"CDM"},{"code":"75989","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4030.00,"discounted_cash":4030.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1813.50,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1773.20,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3627.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3224.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":604.50,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3224.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3425.50,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2740.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3224.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1164.67,"methodology":"percent of total billed charges"}]}]},{"description":"SP SUBCL ANGIO BI ","code_information":[{"code":"276025","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":43632.50,"discounted_cash":43632.50,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4363.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4363.25,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4363.25,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19634.63,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":17287.20,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10733.59,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":10733.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":19198.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":39269.25,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":9730.05,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34906.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":59776.53,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6544.88,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":6544.88,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34906.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":37087.63,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28361.13,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28361.13,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28361.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12609.79,"methodology":"percent of total billed charges"}]}]},{"description":"SP VENOCAVAGM SUP ","code_information":[{"code":"277395","type":"CDM"},{"code":"75827","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":6373.75,"discounted_cash":6373.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1211.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1211.01,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2868.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2804.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5736.38,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1421.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":956.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5417.69,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4334.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1912.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1842.01,"methodology":"percent of total billed charges"}]}]},{"description":"SP VENOGM RENAL BI ","code_information":[{"code":"277435","type":"CDM"},{"code":"75833","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":6373.75,"discounted_cash":6373.75,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1211.01,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":1211.01,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2868.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":2804.45,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5736.38,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":1421.35,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":956.06,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5417.69,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":4334.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":5099.00,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1912.13,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1842.01,"methodology":"percent of total billed charges"}]}]},{"description":"SP VENOGRAM EXT BI ","code_information":[{"code":"288675","type":"CDM"},{"code":"75822","type":"CPT"}],"standard_charges":[{"setting":"outpatient","gross_charge":4353.00,"discounted_cash":4353.00,"payers_information":[{"payer_name":"Aetna","plan_name":"HMO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":827.07,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"PPO","standard_charge_percentage":19.00,"standard_charge_algorithm":"Reimbursement will be 19% of billable gross charges.","estimated_amount":827.07,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1958.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":1915.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":3917.70,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":970.72,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3482.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":652.95,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3482.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":3700.05,"methodology":"percent of total billed charges"},{"payer_name":"Networks by Design","plan_name":"COMM","standard_charge_percentage":68.00,"standard_charge_algorithm":"Reimbursement will be 68% of billable gross charges.","estimated_amount":2960.04,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":3482.40,"methodology":"percent of total billed charges"},{"payer_name":"Redlands Community ","plan_name":"COMM","standard_charge_percentage":30.00,"standard_charge_algorithm":"Reimbursement will be 30% of billable gross charges.","estimated_amount":1305.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1258.02,"methodology":"percent of total billed charges"}]}]},{"description":"SP VERT ANGIO UNILAT ","code_information":[{"code":"466226","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21816.00,"discounted_cash":21816.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2181.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9817.20,"methodology":"percent of total billed charges"},{"payer_name":"Bright Health","plan_name":"COMM","standard_charge_percentage":39.62,"standard_charge_algorithm":"Reimbursement will be 39.62% of billable gross charges.","estimated_amount":8643.50,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"HMO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"PPO","standard_charge_percentage":24.60,"standard_charge_algorithm":"Reimbursement will be 24.6% of billable gross charges.","estimated_amount":5366.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"COMM","standard_charge_percentage":44.00,"standard_charge_algorithm":"Reimbursement will be 44% of billable gross charges.","estimated_amount":9599.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19634.40,"methodology":"percent of total billed charges"},{"payer_name":"Health Net","plan_name":"COMM","standard_charge_percentage":22.30,"standard_charge_algorithm":"Reimbursement will be 22.3% of billable gross charges.","estimated_amount":4864.97,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29887.92,"methodology":"percent of total billed charges"},{"payer_name":"Imperial Insurance","plan_name":"MCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"MedCare Partners","plan_name":"MGMCR","standard_charge_percentage":15.00,"standard_charge_algorithm":"Reimbursement will be 15% of billable gross charges.","estimated_amount":3272.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17452.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18543.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14180.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6304.82,"methodology":"percent of total billed charges"}]}]},{"description":"SPACE BN ACF12.5X15X8MM ","code_information":[{"code":"350078","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":24906.00,"discounted_cash":24906.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2490.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2490.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2490.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11207.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13230.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8204.04,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22415.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19924.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":34121.22,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19924.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21170.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19924.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16188.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16188.90,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":16188.90,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7197.83,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER 20MM LOWER FORT ","code_information":[{"code":"357837","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":12054.00,"discounted_cash":12054.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1205.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1205.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1205.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5424.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6403.08,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3970.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":10848.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9643.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":16513.98,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9643.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10245.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":9643.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7835.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7835.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":7835.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3483.61,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER ACDF 13X15X6MM ","code_information":[{"code":"354735","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":56956.00,"discounted_cash":56956.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5695.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5695.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5695.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":25630.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":30255.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":18761.31,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":51260.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45564.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":78029.72,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45564.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":48412.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":45564.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":37021.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":37021.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":37021.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":16460.28,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER AVS WO HL 4D 7MM ","code_information":[{"code":"174082","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17676.00,"discounted_cash":17676.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7954.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9389.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5822.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15908.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":24216.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5108.36,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER CAMBRA 15X13X11 ","code_information":[{"code":"173740","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER CMNT HIP 10MM ","code_information":[{"code":"355321","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":1401.00,"discounted_cash":1401.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":630.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":744.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":461.49,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":1260.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1120.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1120.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":1190.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":1120.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":404.89,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER COLONIAL ACDF XL ","code_information":[{"code":"359457","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15909.00,"discounted_cash":15909.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7159.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8450.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5240.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14318.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21795.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13522.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4597.70,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER FEM HIP OMFT 11MM ","code_information":[{"code":"355663","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":2508.00,"discounted_cash":2508.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":1128.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":1332.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":826.14,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":2257.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2006.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2006.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":2131.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":2006.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":724.81,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER FEM KN SZ4 8MM ","code_information":[{"code":"174008","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13964.00,"discounted_cash":13964.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6283.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7417.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4599.74,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12567.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11171.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11171.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11869.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11171.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4035.60,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER FRTFY 41-64X20MM ","code_information":[{"code":"357838","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":138148.00,"discounted_cash":138148.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13814.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13814.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":13814.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":62166.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":73384.22,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":45505.95,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":124333.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":110518.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":189262.76,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":110518.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":117425.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":110518.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":89796.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":89796.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":89796.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":39924.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER INTBDY FSN P2010A ","code_information":[{"code":"353332","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":26514.00,"discounted_cash":26514.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2651.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2651.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2651.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11931.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14084.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8733.71,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":23862.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21211.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":36324.18,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21211.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":22536.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":21211.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17234.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17234.10,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":17234.10,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7662.55,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER LRDTC 15X13X9MM ","code_information":[{"code":"25992","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15909.00,"discounted_cash":15909.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1590.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7159.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8450.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5240.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14318.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21795.33,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13522.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12727.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10340.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4597.70,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER LRDTC 55X18X14MM ","code_information":[{"code":"354255","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":70704.00,"discounted_cash":70704.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31816.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":37557.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":23289.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":63633.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":96864.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60098.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":20433.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER LRDTC15 36X28X17 ","code_information":[{"code":"356236","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":49100.00,"discounted_cash":49100.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22095.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26081.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16173.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":44190.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":67267.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":41735.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER PEEK 0-P LODTC8MM ","code_information":[{"code":"351318","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":41244.00,"discounted_cash":41244.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4124.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4124.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4124.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":18559.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":21908.81,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":13585.77,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":37119.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32995.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":56504.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32995.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":35057.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":32995.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26808.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26808.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":26808.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11919.52,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER PEEK 7D 14X11X7MM ","code_information":[{"code":"354649","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29597.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER PRLL 45X18X12MM ","code_information":[{"code":"354193","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":78560.00,"discounted_cash":78560.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":41731.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":25877.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":107627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66776.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22703.84,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SM 14X29 7D ","code_information":[{"code":"385344","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":112459.00,"discounted_cash":112459.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":50606.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":59738.22,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":37043.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":101213.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":154068.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":95590.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":32500.65,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 10D 17X15X8MM ","code_information":[{"code":"388937","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 11X14X8MM ","code_information":[{"code":"350880","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29597.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 12D 37X29X18 ","code_information":[{"code":"915966","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85140.00,"discounted_cash":85140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38313.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45226.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28045.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":76626.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":116641.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72369.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24605.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 12X18X12MM ","code_information":[{"code":"358816","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":94744.00,"discounted_cash":94744.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9474.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9474.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9474.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":42634.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":50328.01,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":31208.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":85269.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75795.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":129799.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75795.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":80532.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":75795.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":61583.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":61583.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":61583.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":27381.02,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 14X16X8MM 7D ","code_information":[{"code":"410951","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 15D 30MM 24MM ","code_information":[{"code":"381584","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":95942.00,"discounted_cash":95942.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":43173.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":50964.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":31603.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":86347.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":131440.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":81550.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":27727.24,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 15X15X8MM ","code_information":[{"code":"409310","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 16X6MM 7D ","code_information":[{"code":"386674","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":37316.00,"discounted_cash":37316.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3731.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16792.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19822.26,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12291.89,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33584.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29852.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":51122.92,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29852.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31718.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29852.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24255.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24255.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":24255.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10784.32,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 18X8X15MM ","code_information":[{"code":"388656","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 24DG 32X2MM ","code_information":[{"code":"435748","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85140.00,"discounted_cash":85140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38313.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45226.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28045.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":76626.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":116641.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72369.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24605.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 24X30X19MM ","code_information":[{"code":"385465","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":95942.00,"discounted_cash":95942.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":9594.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":43173.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":50964.39,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":31603.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":86347.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":131440.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":81550.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":76753.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":62362.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":27727.24,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 27MM 12MM 9MM ","code_information":[{"code":"426807","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":39280.00,"discounted_cash":39280.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20865.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12938.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":53813.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33388.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11351.92,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 31X16-19MM ","code_information":[{"code":"380544","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":103110.00,"discounted_cash":103110.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":46399.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":54772.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":33964.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":92799.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":141260.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":87643.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":29798.79,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 34X17X24MM 8D ","code_information":[{"code":"383031","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":103110.00,"discounted_cash":103110.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10311.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":46399.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":54772.03,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":33964.43,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":92799.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":141260.70,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":87643.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":82488.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":67021.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":29798.79,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 37X29X14MM ","code_information":[{"code":"915967","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85140.00,"discounted_cash":85140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38313.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45226.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28045.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":76626.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":116641.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72369.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24605.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 5D 15X5X7MM ","code_information":[{"code":"434996","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 7D 12X14X42MM ","code_information":[{"code":"23361","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":112459.00,"discounted_cash":112459.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":11245.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":50606.55,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":59738.22,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":37043.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":101213.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":154068.83,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":95590.15,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":89967.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":73098.35,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":32500.65,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN 7D 7X5.5MM ","code_information":[{"code":"434220","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":14730.00,"discounted_cash":14730.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1473.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1473.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1473.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6628.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7824.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4852.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13257.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11784.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":20180.10,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11784.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12520.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":11784.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9574.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9574.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":9574.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4256.97,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN ALEUTIAN 8MM ","code_information":[{"code":"25350","type":"CDM"},{"code":"C1713","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":88380.00,"discounted_cash":88380.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":39771.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":46947.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":29112.37,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":79542.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":75123.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":25541.82,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN LRDTC 15X13X7 ","code_information":[{"code":"352974","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29597.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN ORCL 15X22X15 ","code_information":[{"code":"173917","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":78560.00,"discounted_cash":78560.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":41731.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":25877.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":107627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66776.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22703.84,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN PCFC 24X24X11 ","code_information":[{"code":"352076","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":22095.00,"discounted_cash":22095.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2209.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2209.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2209.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9942.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11736.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7278.09,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19885.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":30270.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18780.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14361.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14361.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14361.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6385.45,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN PK 30X12X13 ","code_information":[{"code":"22472","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":53028.00,"discounted_cash":53028.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23862.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":28168.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":17467.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":47725.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":72648.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45073.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15325.09,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN SYN 12X30X9 ","code_information":[{"code":"23458","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":53028.00,"discounted_cash":53028.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23862.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":28168.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":17467.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":47725.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":72648.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45073.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15325.09,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPN VNTRA 11X28X8 ","code_information":[{"code":"355847","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":49100.00,"discounted_cash":49100.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22095.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26081.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16173.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":44190.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":67267.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":41735.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 13X12X7MM CA ","code_information":[{"code":"391289","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15712.00,"discounted_cash":15712.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1571.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8346.21,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5175.53,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21525.44,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13355.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12569.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10212.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4540.77,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 14X6MM VRTST ","code_information":[{"code":"917704","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":15442.00,"discounted_cash":15442.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1544.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1544.20,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1544.20,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6948.90,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8202.79,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5086.59,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13897.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12353.60,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":21155.54,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12353.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":13125.70,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12353.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10037.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10037.30,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":10037.30,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4462.74,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 16X12MM COAL ","code_information":[{"code":"352789","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":38495.00,"discounted_cash":38495.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3849.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17322.75,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20448.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12680.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":34645.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":52738.15,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":32720.75,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":30796.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25021.75,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11125.06,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 21-29X12MM ","code_information":[{"code":"359772","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":105271.00,"discounted_cash":105271.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10527.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10527.10,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":10527.10,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":47371.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":55919.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":34676.27,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":94743.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84216.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":144221.27,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84216.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":89480.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":84216.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":68426.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":68426.15,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":68426.15,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":30423.32,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 22X8X11MM ","code_information":[{"code":"389416","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":66776.00,"discounted_cash":66776.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6677.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6677.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":6677.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":30049.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":35471.41,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":21996.01,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":60098.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53420.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":91483.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53420.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":56759.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":53420.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43404.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43404.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":43404.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":19298.26,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 24X30X11MM ","code_information":[{"code":"354825","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85140.00,"discounted_cash":85140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38313.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45226.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28045.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":76626.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":116641.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72369.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24605.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 26X24X16 8D ","code_information":[{"code":"172029","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85729.00,"discounted_cash":85729.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8572.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8572.90,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8572.90,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38578.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45539.24,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28239.13,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":77156.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68583.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":117448.73,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68583.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72869.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68583.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55723.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55723.85,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55723.85,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24775.68,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 28X10X9MM ","code_information":[{"code":"351725","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":42865.00,"discounted_cash":42865.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19289.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":22769.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":14119.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":38578.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":58725.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36435.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12387.99,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 30X24X11MM ","code_information":[{"code":"354943","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":85140.00,"discounted_cash":85140.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":8514.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":38313.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":45226.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":28045.12,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":76626.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":116641.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":72369.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":68112.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":55341.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":24605.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 30X24X9MM AL ","code_information":[{"code":"174074","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":53028.00,"discounted_cash":53028.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23862.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":28168.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":17467.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":47725.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":72648.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45073.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15325.09,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 36X28X15MM A ","code_information":[{"code":"173826","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":53028.00,"discounted_cash":53028.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":5302.80,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":23862.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":28168.47,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":17467.42,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":47725.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":72648.36,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":45073.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":42422.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":34468.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":15325.09,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL 55X18X10MM A ","code_information":[{"code":"357672","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":70704.00,"discounted_cash":70704.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7070.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":31816.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":37557.96,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":23289.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":63633.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":96864.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":60098.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":56563.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":45957.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":20433.46,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL CAMB 13X12X7 ","code_information":[{"code":"24538","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17676.00,"discounted_cash":17676.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7954.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9389.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5822.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15908.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":24216.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5108.36,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER SPNL VERT 27X11X9 ","code_information":[{"code":"171616","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":39280.00,"discounted_cash":39280.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":3928.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":17676.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":20865.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12938.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":53813.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":33388.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":31424.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":25532.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":11351.92,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER T-PAL PEEK 12MM ","code_information":[{"code":"359335","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":42865.00,"discounted_cash":42865.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4286.50,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19289.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":22769.89,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":14119.73,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":38578.50,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":58725.05,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":36435.25,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":34292.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":27862.25,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12387.99,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER VERT L26XW10XH11 ","code_information":[{"code":"351159","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":44190.00,"discounted_cash":44190.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4419.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4419.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4419.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":19885.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":23473.73,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":14556.19,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":39771.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":60540.30,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":37561.50,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28723.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28723.50,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":28723.50,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":12770.91,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER VERTEBR L8X30X11M ","code_information":[{"code":"351891","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":49100.00,"discounted_cash":49100.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":4910.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":22095.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":26081.92,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":16173.54,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":44190.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":67267.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":41735.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":39280.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":31915.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":14189.90,"methodology":"percent of total billed charges"}]}]},{"description":"SPACER XPAND 27-34X23X21 ","code_information":[{"code":"353741","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":127444.00,"discounted_cash":127444.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":12744.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":12744.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":12744.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":57349.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":67698.25,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":41980.05,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":114699.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101955.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":174598.28,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101955.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":108327.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":101955.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":82838.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":82838.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":82838.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":36831.32,"methodology":"percent of total billed charges"}]}]},{"description":"SPACR SPN ACIS 14X13X6 ","code_information":[{"code":"354547","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":21604.00,"discounted_cash":21604.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":2160.40,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9721.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11476.04,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7116.36,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19443.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":29597.48,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18363.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17283.20,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":14042.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6243.56,"methodology":"percent of total billed charges"}]}]},{"description":"SPCR ALGRF 14X11X9MM CER ","code_information":[{"code":"354191","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":17676.00,"discounted_cash":17676.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":1767.60,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7954.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9389.49,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5822.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15908.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":24216.12,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15024.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14140.80,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":11489.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5108.36,"methodology":"percent of total billed charges"}]}]},{"description":"SPCR ORCL 55X22MM 13MM 8 ","code_information":[{"code":"174509","type":"CDM"}],"standard_charges":[{"setting":"outpatient","gross_charge":78560.00,"discounted_cash":78560.00,"payers_information":[{"payer_name":"Aetna","plan_name":"MCRHMO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPOS","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"MCRPPO","standard_charge_percentage":10.00,"standard_charge_algorithm":"Reimbursement will be 10% of billable gross charges.","estimated_amount":7856.00,"methodology":"percent of total billed charges"},{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":35352.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":41731.07,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":25877.66,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":70704.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Heritage Provider Network","plan_name":"COMM","standard_charge_percentage":137.00,"standard_charge_algorithm":"Reimbursement will be 137% of billable gross charges.","estimated_amount":107627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":66776.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":62848.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"COMM","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Medical Clinic ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"Riverside Physician ","plan_name":"MCR","standard_charge_percentage":65.00,"standard_charge_algorithm":"Reimbursement will be 65% of billable gross charges.","estimated_amount":51064.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":22703.84,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 14MM 160MM ","code_information":[{"code":"354546","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 15MM 190MM ","code_information":[{"code":"390478","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":47373.00,"discounted_cash":47373.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":21317.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":25164.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15604.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":42635.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37898.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37898.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":40267.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":37898.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13690.80,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 17MM 150MM ","code_information":[{"code":"434288","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21366.00,"discounted_cash":21366.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9614.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11349.62,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7037.96,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19229.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17092.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18161.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17092.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6174.77,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 19MM 115MM ","code_information":[{"code":"915646","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28147.00,"discounted_cash":28147.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12666.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":14951.69,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9271.62,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25332.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22517.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22517.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":23924.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22517.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8134.48,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 23MM ","code_information":[{"code":"407882","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":33137.00,"discounted_cash":33137.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14911.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":17602.37,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10915.33,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":29823.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26509.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26509.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":28166.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":26509.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9576.59,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP 7MM 120MM ","code_information":[{"code":"171810","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17823.00,"discounted_cash":17823.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8020.35,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9467.58,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5870.90,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16040.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14258.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14258.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15149.55,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14258.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5150.85,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP CMNTLS SZ8 ","code_information":[{"code":"424941","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23036.00,"discounted_cash":23036.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12236.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7588.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20732.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19580.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6657.40,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP COCR 135X14 ","code_information":[{"code":"360624","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16974.00,"discounted_cash":16974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9016.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5591.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15276.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14427.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4905.49,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP CONQ 140X12 ","code_information":[{"code":"351643","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16974.00,"discounted_cash":16974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9016.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5591.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15276.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14427.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4905.49,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP LAT SZ6 ","code_information":[{"code":"391300","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP MOD 6 ","code_information":[{"code":"353486","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP MOD P ","code_information":[{"code":"353562","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":6020.00,"discounted_cash":6020.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":2709.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":3197.82,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":1982.99,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":5418.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":5117.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":4816.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":1739.78,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP RT 10.5MM ","code_information":[{"code":"743985","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":29098.00,"discounted_cash":29098.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":13094.10,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15456.86,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9584.88,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":26188.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23278.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23278.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24733.30,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":23278.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8409.32,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP STD SZ12 ","code_information":[{"code":"353208","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":17580.00,"discounted_cash":17580.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7911.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9338.50,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5790.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15822.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14064.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14064.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14943.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14064.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5080.62,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ1 ","code_information":[{"code":"919866","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23036.00,"discounted_cash":23036.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12236.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7588.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20732.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19580.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6657.40,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ12 140MM ","code_information":[{"code":"353031","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23392.00,"discounted_cash":23392.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10526.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12425.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7705.32,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21052.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18713.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18713.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19883.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18713.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6760.29,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ3 ","code_information":[{"code":"915425","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":18186.00,"discounted_cash":18186.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":8183.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9660.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5990.47,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":16367.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":15458.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":14548.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":5255.75,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ4 103MM ","code_information":[{"code":"387198","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23036.00,"discounted_cash":23036.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10366.20,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12236.72,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7588.06,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":20732.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19580.60,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18428.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6657.40,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ5 145MM ","code_information":[{"code":"389302","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ7 109MM ","code_information":[{"code":"391396","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23424.00,"discounted_cash":23424.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10540.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12442.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7715.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21081.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19910.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6769.54,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP SZ9 12/14 ","code_information":[{"code":"387002","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":24248.00,"discounted_cash":24248.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10911.60,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12880.54,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7987.29,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21823.20,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":20610.80,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":19398.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7007.67,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM HIP TYPE1 SZB ","code_information":[{"code":"390472","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":45784.00,"discounted_cash":45784.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":20602.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":24320.46,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":15081.25,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":41205.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":38916.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":36627.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":13231.58,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN 110MM 12MM ","code_information":[{"code":"412857","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":12709.00,"discounted_cash":12709.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":5719.05,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":6751.02,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4186.34,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":11438.10,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10167.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":10802.65,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10167.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3672.90,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN 120X15MM ","code_information":[{"code":"355578","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10133.00,"discounted_cash":10133.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4559.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5382.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3337.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9119.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8613.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2928.44,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN 13MM 135MM ","code_information":[{"code":"391402","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":28371.00,"discounted_cash":28371.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":12766.95,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":15070.68,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":9345.41,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":25533.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22696.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22696.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":24115.35,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":22696.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":8199.22,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN 160MM 12MM ","code_information":[{"code":"380800","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10133.00,"discounted_cash":10133.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4559.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5382.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3337.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9119.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8613.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2928.44,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN 18MM 120MM ","code_information":[{"code":"388404","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10133.00,"discounted_cash":10133.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4559.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5382.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3337.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9119.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8613.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2928.44,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM KN EVOL SZ4 L ","code_information":[{"code":"358670","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":21824.00,"discounted_cash":21824.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":9820.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":11592.91,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7188.83,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":19641.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":18550.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":17459.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6307.14,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM L45MM OD13.5MM ","code_information":[{"code":"173633","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":81667.00,"discounted_cash":81667.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":36750.15,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":43381.51,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":26901.11,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":73500.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65333.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65333.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":69416.95,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":65333.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":23601.76,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM LGN PRSFT160X16 ","code_information":[{"code":"357674","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":10133.00,"discounted_cash":10133.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":4559.85,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":5382.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":3337.81,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":9119.70,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":8613.05,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":8106.40,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2928.44,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM NCLR OFST135X11 ","code_information":[{"code":"351883","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31826.00,"discounted_cash":31826.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14321.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16905.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10483.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28643.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27052.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9197.71,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM POR 140X12 HP ","code_information":[{"code":"171714","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31826.00,"discounted_cash":31826.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14321.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16905.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10483.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28643.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27052.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9197.71,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM PRFT HP 16X145 ","code_information":[{"code":"26242","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":13337.00,"discounted_cash":13337.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6001.65,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":7084.61,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4393.21,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":12003.30,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10669.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10669.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":11336.45,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":10669.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":3854.39,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM RDC FLR 135X31 ","code_information":[{"code":"351067","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":25461.00,"discounted_cash":25461.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":11457.45,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":13524.88,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":8386.85,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":22914.90,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":21641.85,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":20368.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":7358.23,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM REV XTN 16.5X75 ","code_information":[{"code":"24119","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":8812.00,"discounted_cash":8812.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":3965.40,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":4680.93,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":2902.67,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":7930.80,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7049.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7049.60,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":7490.20,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":7049.60,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":2546.67,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM STD OFST SZ9 ","code_information":[{"code":"351676","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":36704.00,"discounted_cash":36704.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":16516.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":19497.16,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":12090.30,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":33033.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29363.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":31198.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":29363.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":10607.46,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM SZ5 108MM ","code_information":[{"code":"359266","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":23424.00,"discounted_cash":23424.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":10540.80,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":12442.83,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":7715.87,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":21081.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":19910.40,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":18739.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":6769.54,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM TI PRS FIT 10MM ","code_information":[{"code":"352444","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16974.00,"discounted_cash":16974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":9016.59,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":5591.24,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":15276.60,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":14427.90,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":13579.20,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4905.49,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FEM X11-170310 ","code_information":[{"code":"171728","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":31826.00,"discounted_cash":31826.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":14321.70,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":16905.97,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":10483.48,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":28643.40,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":27052.10,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":25460.80,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":9197.71,"methodology":"percent of total billed charges"}]}]},{"description":"STEM FLUTED UNIV 75X70 ","code_information":[{"code":"175029","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":15100.00,"discounted_cash":15100.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":6795.00,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algorithm":"Reimbursement will be 53.12% of billable gross charges.","estimated_amount":8021.12,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"EPN","standard_charge_percentage":32.94,"standard_charge_algorithm":"Reimbursement will be 32.94% of billable gross charges.","estimated_amount":4973.94,"methodology":"percent of total billed charges"},{"payer_name":"First Health ","plan_name":"WCOMP","standard_charge_percentage":90.00,"standard_charge_algorithm":"Reimbursement will be 90% of billable gross charges.","estimated_amount":13590.00,"methodology":"percent of total billed charges"},{"payer_name":"HealthSmart","plan_name":"COMM","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12080.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMCOMPLEMENTARYPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12080.00,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan ","plan_name":"COMMPRIMARYPPO","standard_charge_percentage":85.00,"standard_charge_algorithm":"Reimbursement will be 85% of billable gross charges.","estimated_amount":12835.00,"methodology":"percent of total billed charges"},{"payer_name":"Next","plan_name":"COMMPPO","standard_charge_percentage":80.00,"standard_charge_algorithm":"Reimbursement will be 80% of billable gross charges.","estimated_amount":12080.00,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"OptionsPPO","standard_charge_percentage":28.90,"standard_charge_algorithm":"Reimbursement will be 28.9% of billable gross charges.","estimated_amount":4363.90,"methodology":"percent of total billed charges"}]}]},{"description":"STEM HIP 127D SZ3 131MM ","code_information":[{"code":"917546","type":"CDM"},{"code":"C1776","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","gross_charge":16974.00,"discounted_cash":16974.00,"payers_information":[{"payer_name":"American Health System","plan_name":"HIX","standard_charge_percentage":45.00,"standard_charge_algorithm":"Reimbursement will be 45% of billable gross charges.","estimated_amount":7638.30,"methodology":"percent of total billed charges"},{"payer_name":"Blue Shield","plan_name":"Comm","standard_charge_percentage":53.12,"standard_charge_algor